My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO_2023
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
E
>
EL DORADO
>
1901
>
2300 - Underground Storage Tank Program
>
PR0231092
>
COMPLIANCE INFO_2023
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/20/2023 5:13:57 PM
Creation date
2/23/2023 11:45:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0231092
PE
2361
FACILITY_ID
FA0001946
FACILITY_NAME
El Dorado Food Mart
STREET_NUMBER
1901
Direction
S
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
16508019
CURRENT_STATUS
01
SITE_LOCATION
1901 S EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
44
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Appendix VIII <br /> Underground Storage Tank <br /> Spill Container Testing Report Form <br /> TYPE OF ACTION ❑ Installation ❑ Repair ❑✓ 12 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID 10180839 Test Date 8/25/2022 <br /> Facility NameELDORADO FOOD MART <br /> Facility AddressCity <br /> S.EL DORADO STREET C�tyZIP Code <br /> STOCKTON <br /> 95206 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing the Test Phone <br /> Afforda Test 209-744-0112 <br /> Mailing Address 416 2nd St Galt CA 95632 <br /> Service Technician Performing Test Ed Stearns <br /> Contractor/Tank Tester License Number 08-1740 Ex. 5-31 -23 <br /> ICC NumberICCICC Expiration Date <br /> 11/6/2022 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> Franklin Fueling - EBW & Phil Tite #1009893708 11/28/2022 <br /> OPW #104-635 3/12/2022 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tested <br /> LAKE TEST SPILL BUCKETS <br /> 5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> I hereby certify that each spill container was tested in accordance with California Code of <br /> Regulations, title 23, division 3, chapter 16, section 2637.1; that required supporting <br /> documentation is attached; and all information contained herein is accurate. I understand <br /> that test procedures shall be made available upon request by the governing authority. <br /> Service Technician Signature Date8/25/2022 Total # of Pages <br /> OL,&ffd Otte 2 <br /> CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br /> Council <br /> Page 1 of 2 <br />
The URL can be used to link to this page
Your browser does not support the video tag.