Laserfiche WebLink
RECEIVED <br /> SEP 2 2 2016 <br /> I. FACILITY INFORMATION ENVIRONMENTAL HEALTH <br /> Facility Name: Rancho San Miguel Date of Tcs[ing: 9/20EPARTMENT <br /> . Facility Address: 610 South Cherokee Lane—Lodi CA 95240 <br /> Facility Contact: Phone: (209)339-8200 <br /> Date Local Agency Was Notified of Testing:8/9/16 SB989—3yr.Compliance Test <br /> Name of Local Agency Inspector(ifpresent during testing): <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name:ABLE Maintenance,Inc. <br /> Technician Conducting Test: James Moore/I.C.C.#5254517-UT <br /> Credentials: ® CSLB Licensed Contractor ❑SWRCB Licensed Tank Tester <br /> License Type:A,B,Ha&,C10 License Number: 312844 <br /> Manufacturer Training <br /> Manufacturer Component(s) DateTraining Expires <br /> Available upon request <br /> 3. SUMMARY OF TEST RESULTS <br /> Com onent: Pass Fail Not Repairs Component-. Pass Fail Not Repairs <br /> P Tested Made Tested Made <br /> 87/91 Tank Annular ® go <br /> 13 [187 Secondary Product ® El ❑ <br /> 91 Secondary Product rEm <br /> ❑ ❑ <br /> Vent Vapor ❑ ❑ 1187 Turbine Sump ❑ ❑ ❑ <br /> 91 Turbine Sump ® ❑ ❑ ❑ <br /> UDC 1/2 ® ❑ ❑ ❑ <br /> UDC 3/4 ® ❑ ❑ ❑ <br /> UDC 5/6 ❑4 ❑ ❑ ❑ <br /> 87 Fill Sump © ❑ ❑ ❑ <br /> 91 Fill Sump ❑D ❑ ❑ ❑ <br /> If hydrostatic testing was performed,describe what was done with the water after completion of tests: <br /> Used pump test truck. <br />