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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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PR0232355
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
11/4/2022 11:09:23 AM
Creation date
4/7/2021 4:10:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0232355
PE
2361
FACILITY_ID
FA0000591
FACILITY_NAME
QUIK STOP MARKET #152
STREET_NUMBER
1721
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
062-060-48
CURRENT_STATUS
01
SITE_LOCATION
1721 S CHEROKEE LN # 1
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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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 T1 - 87 T2 - 91 T3 - Diesel <br /> Spill Container Manufacturer: OPW OPW OPW <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* 0 No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ❑ Drain [M Drain ❑ Drain ❑ Drain <br /> empty ® Pump © Pump © Pump ❑ Pump <br /> [F] Other M Other © Other ❑ Other <br /> Spill Container Test Results C Pass D Pass ❑ Pass ❑ Pass <br /> Fail I ❑ Fail I ® Fail 1 ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection © Nonmetallic [F] Nonmetallic [r] Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* 7 No* © No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ® Drain ❑ Drain ❑ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> 0 Other ® Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass © Pass ❑ Pass <br /> ❑ Fail © Fail 0 Fail © Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," 'Wo,"or "Fail"and each proposed remedy. <br /> * Mark here if: <br /> 0 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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