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COMPLIANCE INFO_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MOUNTAIN HOUSE
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19533
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2300 - Underground Storage Tank Program
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PR0547762
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
1/18/2024 3:16:40 PM
Creation date
1/23/2023 11:19:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0547762
PE
2351
FACILITY_ID
FA0027204
FACILITY_NAME
SAFEWAY FUEL CENTER #0055
STREET_NUMBER
19533
Direction
S
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
01
SITE_LOCATION
19533 S MOUNTAIN HOUSE PKWY
QC Status
Approved
Scanner
SJGOV\lsauers1
Tags
EHD - Public
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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> Test Type ❑ Pressure ❑ Vacuum ® Hydrostatic <br /> Tank ID Tank 1 87 Tank 2 91 Tank 89 DSL <br /> Spill Container Manufacturer: OPW OPW OPW <br /> Method of Cathodic Protection ® Nonmetallic ® Nonmetallic ® Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ® Yes ® Yes ® Yes ❑ Yes <br /> capacity five gallons excluding riser ❑ No* ElNo* ❑ No* [INo* <br /> volume? <br /> ® Drain ® Drain ® Drain ❑ Drain <br /> Method to keep spill container El Pump El Pump El Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ® Pass ® Pass ® Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding riser ❑ No* ❑ No* ❑ No* ❑ No* <br /> volume? <br /> Method to keep spill container El Drain El Drain El Drain El Drain <br /> empty El Pump El Pump El Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ 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 /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />
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