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COMPLIANCE INFO_2021
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231669
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
8/30/2022 11:20:13 AM
Creation date
4/1/2021 8:34:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231669
PE
2361
FACILITY_ID
FA0001480
FACILITY_NAME
JACKSONS ENERGY #6822
STREET_NUMBER
2132
STREET_NAME
MARIPOSA
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
17306035
CURRENT_STATUS
01
SITE_LOCATION
2132 MARIPOSA RD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by ❑✓ Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ vacuum ❑✓ Hydrostatic <br /> Tank ID T-1 Regular T-2 Plus T-3 Premium T-4 Diesel <br /> Spill Container Manufacturer: oPw oPw oPw oPw <br /> Method of Cathodic Protection <br /> ❑✓ Nonmetallic ❑✓ Nonmetallic ❑✓ Nonmetallic ❑✓ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑✓ Yes ❑✓ Yes ✓❑ Yes ❑✓ Yes <br /> capacity five gallons excluding <br /> riser volume? ❑ No* ❑ No* ❑ No* ❑ No* <br /> Method to keep spill container ❑✓ Drain ❑✓ Drain ❑✓ Drain ❑✓ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑Other ❑Other ❑ Other <br /> Spill Container Test Results ZPass ZPass ZPass ZPass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding No* No* No* No* <br /> riser volume? E] No* ❑ ❑ <br /> ❑ Drain El Drain E] Drain E] Drain <br /> Method to keep spill container EJPump ElPump ElPump ElPump <br /> empty <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," 'Wo,"or "Fail"and each proposed remedy. <br /> * Mark here if: <br /> ❑ Spill containers do not have a minimum capacity of five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />
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