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COMPLIANCE INFO_2024
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0516526
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
10/30/2024 3:16:57 PM
Creation date
7/31/2024 12:52:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0516526
PE
2351 - UST FACILITY - 2481 COMPLIANT
FACILITY_ID
FA0012659
FACILITY_NAME
LOVES COUNTRY STORES OF CALIFORNIA #223
STREET_NUMBER
1553
STREET_NAME
COLONY
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
24534024
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\lsauers1
Supplemental fields
Site Address
1553 COLONY RD RIPON 95366
Tags
EHD - Public
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UNDERGROUND STORAGE TANK <br />TANK AND LINE INTEGRITY TESTING, AND ENHANCED LEAK <br />DETECTION TEST NOTIFICATION FORM <br />OFFICE OF TANK TESTER LICENSING <br />OTTL@waterboards.ca.gov <br />Test notifications for testing tank and line integrity testing, and enhanced leak detection (ELD) <br />testing are required to be submitted to the Office of Tank Tester Licensing (OTTL) in accordance <br />with the California Code of Regulations, tile 23, chapter 17, section 2772. If changes to test <br />notifications occur after submittal to OTTL, please notify OTTL of those changes immediately. <br />Using this form, provide OTTL with the following information when submitting test notifications: <br />SUBMITTAL DATE: _______________________ <br />FACILITY INFORMATION <br />CERS ID Test Date and Time <br />Facility Name <br />Facility Address City ZIP Code <br />TANK TESTER INFORMATION <br />Company Performing the Test Phone <br />Mailing Address <br />Licensee Name <br />OTTL License # Expiration Date <br />TEST METHOD INFORMATION <br />Test Method Components Tested <br /> If no is selected, provide general contractor statement prior to testing. <br />Post Construction ELD: Is the form for post construction contractor statement attached? <br />YES NO <br />Failure to comply and provide all of the above information may result in disciplinary action against <br />licensed tank tester. Please note that this notification does not waive the requirement for the <br />48-hour notice to the local agency in accordance with the provisions of California Code of <br />Regulations, title 23, chapter 16, sections 2643(g) and 2644.1(a)(4). <br />June 2020
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