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COMPLIANCE INFO_2022
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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PR0231995
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COMPLIANCE INFO_2022
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Last modified
11/2/2022 11:51:23 AM
Creation date
3/23/2022 2:57:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231995
PE
2361
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
01
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Underground Storage Tank <br />Secondary Containment Testing Report Form <br />All tests marked “Fail” and any repairs made before or during the tightness test must be described in <br />the COMMENTS section. <br />Page 2 of 5 <br />Test Method Developed by ☒ Manufacturer ☒ Industry Standard ☐ Professional Engineer <br />Test Type ☐Pressure ☒Vacuum ☐Hydrostatic <br />Test Equipment Used: 0-30inHg. 4” Vacuum Gauges w/ 0.05 graduations <br />Tank ID <br />Tank Manufacturer <br />Tank Capacity <br />Test Start Time <br />Initial Reading <br />Test End Time <br />Final Reading <br />Change in Reading <br />Pass/Fail Criteria No Loss No Loss No Loss No Loss <br />Tightness Test Results ☐Pass ☐ Fail ☐Pass ☐ Fail ☐Pass ☐ Fail ☐Pass ☐ Fail <br />Test Method Developed by ☒ Manufacturer ☒ Industry Standard ☐ Professional Engineer <br />Test Type ☒Pressure ☐Vacuum ☐Hydrostatic <br />Test Equipment Used: Dual 0-15psi 4” Pressure Gauges w/ 0.05 graduations <br />Pipe Run ID T-1 DSL Product T-2 87 Product T-3 91 Product <br />Pipe Manufacturer A.O. Smith A.O. Smith A.O. Smith <br />Test Start Time 9:00am 9:00am 9:00am <br />Initial Reading 5psi 5psi 5psi <br />Test End Time 10:00am 10:00am 10:00am <br />Final Reading 5psi 5psi 5psi <br />Change in Reading 0.00 0.00 0.00 <br />Pass/Fail Criteria No Loss No Loss No Loss No Loss <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 No Loss No Loss No Loss No Loss <br />Tightness Test Results ☐Pass ☐ Fail ☐Pass ☐ Fail ☐Pass ☐ Fail ☐Pass ☐ Fail <br />6. TANK SECONDARY CONTAINMENT TEST <br />7. PIPE SECONDARY CONTAINMENT TEST
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