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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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PR0232523
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
12/28/2021 3:10:00 PM
Creation date
6/17/2021 10:43:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0232523
PE
2361
FACILITY_ID
FA0003833
FACILITY_NAME
Super Store Industries - Grocery Division
STREET_NUMBER
16888
STREET_NAME
MCKINLEY
STREET_TYPE
Ave
City
Lathrop
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
16888 McKinley Ave
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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Underground Storage Tank Permit # SR0083831 <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by El Manufacturer ® Industry Standard ® Professional Engineer <br /> Test Type ® Pressure ® Vacuum ® Hydrostatic <br /> Tank ID Diesel <br /> Spill Container Manufacturer: Xerxes corp. <br /> Method of Cathodic Protection ® Nonmetallic ® Nonmetallic ® Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ® Other ® Other <br /> Is the spill container minimum <br /> ® Yes ® Yes ® Yes ® Yes <br /> capacity five gallons excluding ® No* ® No* rl No* ® No* <br /> riser volume? <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 0 Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection ® Nonmetallic ® Nonmetallic ® Nonmetallic ® Nonmetallic <br /> ® Other ® Other IM Other ❑ Other <br /> Is the spill container minimum ® Yes ® Yes ® Yes ® Yes <br /> capacity five gallons excluding ® No* ® No* IM No* ® No* <br /> riser volume? <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 E! Pass ❑ Pass ❑ Pass rl Pass <br /> ® Fail ® Fail ® Fail ® Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," "No," or"Fail" and each proposed remedy. <br /> * Mark here if: <br /> ® S ill 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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