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COMPLIANCE INFO_2022
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0508452
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
6/16/2022 10:37:51 AM
Creation date
3/3/2022 9:53:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0508452
PE
2361
FACILITY_ID
FA0007787
FACILITY_NAME
7-ELEVEN INC #41341
STREET_NUMBER
4405
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11024013
CURRENT_STATUS
01
SITE_LOCATION
4405 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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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 Z Manufacturer ❑ Industry Standard ❑ Professfonai Engineer <br />Test Type Ll Pressure 0 Vacuum ❑ Hydrostatic <br />Tank ID <br />RUL. <br />PUL. <br />Spill Container Manufacturer. <br />oPw <br />oPw <br />Nonmetallic <br />0 Nonmetallic <br />11 Nonmetallic <br />❑ Nonmetallic <br />Method of Cathodic Protection <br />P Other <br />❑ Other <br />❑ Other <br />El Other <br />Is the spill container minimum <br />R: yes <br />0 Yes <br />❑ Yes <br />❑ Yes <br />capacity five gallons excluding <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ No* <br />riser volume? <br />R1 Drain <br />R1 Drain <br />❑ Drain <br />D Drain <br />Method to keep spill container <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />Li Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />Spill Container Test Results <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />Tank ID <br />Spill Container Manufacturer: <br />11Nonmetatlie <br />11 Nonmetallic <br />El Nonmetallic <br />❑ Nonmetallic <br />Method of Cathodic Protection <br />❑ Other <br />❑ Other <br />❑ Other <br />LJ Other <br />Is the spill container minimum <br />❑ yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />capacity five gallons excluding <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ No* <br />riser volume? <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />Method to keep spill container <br />❑ pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />D Pass <br />❑ Pass <br />Ll Pass L2Pass <br />Spill Container Test Results <br />Q Fail <br />❑ Fail <br />❑ Fail ❑ Fail <br />8. COMMENTS <br />Describe all answers marked "Other." "No," 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 />Additionaf copies of this page may be attached. <br />Page 2 of 2 <br />
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