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COMPLIANCE INFO_2024
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231604
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COMPLIANCE INFO_2024
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Last modified
6/19/2024 4:34:14 PM
Creation date
2/20/2024 1:34:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0231604
PE
2361
FACILITY_ID
FA0000650
FACILITY_NAME
GAS & SHOP
STREET_NUMBER
1002
STREET_NAME
FRONTAGE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
26102012
CURRENT_STATUS
01
SITE_LOCATION
1002 FRONTAGE RD
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> C. SPILL CONTAINER DETAILS <br /> Test Method Developed by F Manufacturer F Industry Standard ❑ Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ® Hydrostatic <br /> Tank ID T# 1 regular T # 2 super <br /> Spill Container Manufacturer: OPW OPW <br /> Method of Cathodic Protection F Nonmetallic F Nonmetallic ® Nonmetallic ® Nonmetallic <br /> ® Other ® Other m Other ❑ Other <br /> Is the spill container minimum F Yes F Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ® No* ® No* p'J No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ® Drain ® Drain ❑ Drain ❑ Drain <br /> empty ® Pump F Pump ❑ Pump ❑ Pump <br /> ® Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results MPass F Pass ❑ Pass E] 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 ® No* ® No* ® No* El No* <br /> riser volume? <br /> Method to keep spill container ® Drain ❑ Drain ® Drain ❑ Drain <br /> empty ® Pump ❑ Pump [7 Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ® Pass ® Pass ® Pass ❑ Pass <br /> ❑ Fail ® Fail ❑ Fail LC Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," "No,"or "Fail" and each proposed remedy. <br /> regular fill bucket failed initial test, replaced fill adapter gskt and tightened fitting, replace <br /> fill cap and retested with passing results <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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