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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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PR0537549
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
8/3/2023 11:49:02 AM
Creation date
1/17/2023 11:06:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0537549
PE
2351
FACILITY_ID
FA0021617
FACILITY_NAME
HARNEY LANE AM PM
STREET_NUMBER
255
Direction
E
STREET_NAME
HARNEY
STREET_TYPE
Ln
City
Lodi
Zip
95240
APN
062-580-40
CURRENT_STATUS
01
SITE_LOCATION
255 E Harney Ln
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
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 ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br />Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br />11 Tank ID 187 E 191 1 1 11 <br />Spill Container Manufacturer: <br />OPW <br />OPW <br />Tank ID <br />Method of Cathodic Protection <br />® <br />Nonmetallic <br />❑ Nonmetallic <br />® Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />® <br />Other <br />® <br />Other <br />❑ <br />Other <br />® <br />Other <br />Is the spill container minimum <br />Is the spill container minimum <br />capacity five gallons excluding <br />❑ <br />Yes <br />❑ <br />Yes <br />® <br />Yes <br />® <br />Yes <br />riser volume? <br />®No* <br />riser volume? <br />❑ <br />No* <br />❑ <br />No* <br />❑ <br />No* <br />Method to keep spill container <br />❑ <br />Drain <br />® <br />Drain <br />❑ <br />Drain <br />❑ <br />Drain <br />empty <br />❑ <br />Pump <br />❑ <br />Pump <br />❑ <br />Pump <br />❑ <br />Pump <br />❑ <br />❑ <br />Other <br />in <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />Spill Container Test Results <br />3.7 <br />Pass <br />® <br />Pass <br />17 <br />Pass <br />El <br />Pass <br />® <br />I l <br />Fail <br />I rl <br />Fail <br />I rn <br />Pnil <br />I n <br />c --;i <br />Spill container Manufacturer: <br />Tank ID <br />Method of Cathodic Protection <br />Spill container Manufacturer: <br />Method of Cathodic Protection <br />❑ <br />Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />® <br />Other <br />E] <br />Other <br />® <br />Other <br />E]Other <br />Is the spill container minimum <br />capacity five gallons excluding <br />®Yes <br />❑ <br />Yes <br />❑ <br />Yes <br />❑ <br />Yes <br />riser volume? <br />❑ <br />No* <br />® <br />No* <br />® <br />No* <br />❑ <br />No* <br />Method to keep spill container <br />® <br />Drain <br />❑ <br />Drain <br />❑ <br />Drain <br />❑ <br />Drain <br />empty <br />® <br />Pump <br />❑ <br />Pump <br />❑ <br />Pump <br />❑ <br />Pump <br />❑ <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />Spill Container Test Results <br />® <br />Pass <br />❑ <br />Pass <br />❑ <br />Pass <br />® <br />Pass <br />ElFail <br />❑Fail <br />I <br />®Fail <br />Fail <br />8. COMMENTS <br />_L17 <br />Describe all answers marked "Other, <br />" <br />"No, " or "Fail' and each proposed remedy. <br />Replaced fill adaptors and caps <br />on <br />87 quad east and <br />91 buckets. <br />Retested and passed. <br />* Mark here if: <br />❑ Spill containers do not have a minimum ca <br />Additional copies of this page may be attached. <br />of five gallons and require replacement. <br />Page 2 of 2 <br />
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