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COMPLIANCE INFO_2023
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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PR0232601
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
3/21/2024 3:14:57 PM
Creation date
1/17/2023 11:00:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0232601
PE
2361
FACILITY_ID
FA0004525
FACILITY_NAME
CHEVRON STATION #372736/2223
STREET_NUMBER
9484
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09055063
CURRENT_STATUS
01
SITE_LOCATION
9484 WEST LN
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\lsauers1
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EHD - Public
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Underground Storage Tank <br />Spill Container Testing Report Form <br />6. SPILL CONTAINER DETAILS I <br />Test Method Developed by D Manufacturer ® Industry Standard D Professional Engineer <br />Test Type Ll Pressure 0 'Vacuum Ll Hydrostatic <br />Tank ID <br />sup. <br />reg. <br />DSL <br />Spill Container Manufacturer. <br />opw <br />opw <br />opw <br />A Nonmetallic <br />A Nonmetallic <br />A Nonmetallic <br />Ll Nonmetallic <br />Method of Cathodic Protection <br />El Other <br />1:1 Other <br />El Other <br />D Other <br />Is the spill container minimum <br />Z Yes <br />A Yes <br />0 Yes <br />L2 Yes <br />capacity five gallons excluding <br />El No* <br />Ll No* <br />Ll No* <br />L3 No* <br />riser volume? <br />A Drain <br />0 Drain <br />A Drain <br />J Drain <br />Method to keep spill container <br />Q Pump <br />L Pump <br />LJ Pump <br />LJ Pump <br />empty <br />L=� Other <br />Q Other <br />D Other <br />D Other <br />Q Pass <br />Z Pass <br />21 Pass <br />� Pass <br />Spill Container Test Results <br />I- Fail <br />0 Fail <br />LJ Fail <br />Fail <br />Tank ID <br />Spill Container Manufacturer: <br />D Nonmetallic <br />LJ Nonmetallic <br />EJ Nonmetallic <br />D Nonmetallic <br />Method of Cathodic Protection <br />LJ Other <br />Ll Other <br />LJ Other <br />L=J Other <br />Is the spill container minimum <br />® Yes <br />Ll fifes <br />Ll Yes <br />Ll Yes <br />capacity five gallons excluding <br />Ll No* <br />Ll No* <br />Ll No* <br />L2 No* <br />riser volume? <br />LJ Drain <br />Lf Drain <br />Lj Drain <br />❑J Drain <br />Method to keep spill container <br />g Pump <br />Q Pump <br />EJ PLI MP <br />D PUMP <br />GM Pty <br />D Other <br />J Other <br />EJ Other <br />2 Other <br />J Pass <br />LJ Pass <br />Ll Pass J Pass <br />Spill Container Test Results <br />Q Fail <br />L:J Fail <br />Lj Fail iJ Fail <br />B. COMMENTS <br />Describe all answers marked "Other." "No," or `'f=ail" and each proposed re m, edy. <br />* Mark here if: <br />Ll 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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