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COMPLIANCE INFO_2023
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231906
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COMPLIANCE INFO_2023
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Last modified
12/28/2023 11:26:19 AM
Creation date
1/10/2023 9:09:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0231906
PE
2361
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\bmascaro
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EHD - Public
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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 6. SENSOR TESTING RESULTS _ <br /> ( List only sensors tested on date of this certification. List "Sensor iD" as labeled in system <br /> programming. Additional copies of this page may be attached to accommodate all sensors tested. <br /> Sensor lD Sensor Model Component(s) Monitored Pass Fail <br /> L1 VR 208 87 STP ® ❑ <br /> L2 VR 208 DSL STP ® ❑ <br /> L3 VR 208 91 STP ® ❑ <br /> L4 VR 208 E-85 STP ® ❑ <br /> L6 WRAPAROUND 87-91 ANN ® ❑ <br /> L9 VR 208 DISP 1-2 ® ❑ <br /> L10 VR 208 DISP 3-4 z ❑ <br /> L11 VR .208 DISP 5-6 ® ❑ <br /> L12 VR 208 DISP 7-8 ® ❑ <br /> L13 VR 323 DISP 9-10 ® ❑ <br /> L14 VR 420 WO ANN ® ❑ <br /> L15 HI LIQ FLOAT HI LIMIT ® ❑ <br /> C1 WRAP AROUND E-851DSL ANN ® ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> Describe all answers marked "No" or "Fail" and proposed remedy in Section 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> i <br />
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