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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231309
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
1/4/2022 11:10:32 AM
Creation date
4/5/2021 1:49:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231309
PE
2361
FACILITY_ID
FA0003756
FACILITY_NAME
KISHIDA, GEORGE INC
STREET_NUMBER
1725
STREET_NAME
ACKERMAN
STREET_TYPE
DR
City
LODI
Zip
95240
APN
06219001
CURRENT_STATUS
01
SITE_LOCATION
1725 ACKERMAN DR
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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Underground Storage Tank <br /> `Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST (ANNULAR) <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ® Vacuum ❑ Hydrostatic <br /> Test Equipment Used: PEI/ RP1200/ 10Hg for 1 hr <br /> Tank ID DSL <br /> Tank Manufacturer Unknown <br /> Tank Capacity N/A <br /> Test Start Time 10:35 <br /> Initial Reading -10 <br /> Test End Time 11:35 <br /> Final Reading -10 <br /> Change in Reading 0 <br /> Pass/Fail Criteria 0 0 0 0 <br /> Tightness Test Results I ® Pass ❑ Fail I ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST (SEC LINE) <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: PEI/ RP1200/ 5 psi for 1 HR <br /> Pipe Run ID DSL 1 DSI- 2 <br /> Pipe Manufacturer Unknown Unknown <br /> Test Start Time 10:40 10:50 <br /> Initial Reading 5 5 <br /> Test End Time 11:40 11:50 <br /> Final Reading 5 5 <br /> Change in Reading 0 0 <br /> Pass/Fail Criteria 0 0 0 0 <br /> Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Pipe Run ID <br /> Pipe Manufacturer <br /> Test Start Time <br /> Initial Reading <br /> Test End Time <br /> Final Reading <br /> Change in Reading <br /> Pass/Fail Criteria 0 0 0 0 <br /> Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Page 2 of 6 <br />
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