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COMPLIANCE INFO 2010-2012
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0518624
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COMPLIANCE INFO 2010-2012
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Last modified
3/11/2021 9:19:03 AM
Creation date
11/5/2018 11:19:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2010-2012
RECORD_ID
PR0518624
PE
2371
FACILITY_ID
FA0024496
FACILITY_NAME
Costco Wholesale #38 (Gas Station)
STREET_NUMBER
1630
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
Ln
City
Stockton
Zip
95210
APN
09428011
CURRENT_STATUS
01
SITE_LOCATION
1630 E Hammer Ln
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\H\HAMMER\1630\PR0518624\COMPLIANCE INFO 2010-2012.PDF
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EHD - Public
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4162"dStreet Phone: (209)744-0112 LINE & LEAK DETECTOR <br /> Galt,Ca 95632 Fax: (209)744-0116 TEST REPORT <br /> afforda@softcom.net <br /> CONTRACTOR/ENGINEER ELITE IV <br /> TEST DATE 7/ 11 / I 1 <br /> SITE NAME 279355 COSTCO#38 <br /> PHONE <br /> SITE ADDRESS 1616 E. HAMMER LANE <br /> CITY : STOCKTON, CA <br /> Repair/Construction LOCATION SKETCH Show North —0 <br /> Compliance ❑ Owners Request SUP43 RUL#2 RULNI <br /> Insurance Escrow <br /> Other <br /> Make&Type of Pump or Dispenser go <br /> GILBARCO/FEP <br /> Cover Over Lines <br /> CONCRETE <br /> Approx Burial Depth <br /> 50" <br /> Weather <br /> WARM <br /> Pressure Suction <br /> SHOW STREETS,SLOGS,TANKS,ISLANDS,PIPING IF KNOWN),PUMPS OR DISPENSERS <br /> Calibrate <br /> LEAK DETECTOR FTA LEAK DETECTOR TEST INFORMATION 10 PSI <br /> Opening Test Leak I Element <br /> KEY TYPES No/ LD Serial Resiliency Timeln Rate Holding Metering Pass/ <br /> Product Key Number Seconds ML/Min. PSI PSI Fall <br /> A LD 2000 N/A <br /> B LD 2000 E <br /> C FXI V <br /> D FXI DV <br /> E STPMLD <br /> F STPMLD— D <br /> G STPMLD — E <br /> H STPMLD—D/E Notes: <br /> CONTRACTOR LINE TEST RESULTS <br /> CERTIFICATION <br /> Technician: Lyle Nimmo Tests were made on the line systems as noted in accordance with test procedures <br /> prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br /> v LINE IDENTIFICATION NET VOLUME CHANGE PER HOUR <br /> PETROTITECERTA: CCA: 0201029110 SUP ®PASS ❑FAIL ❑INCONCLUSNE }.0080 <br /> ICC#5249115UT EX.6-30-11 PASS FAIL fNCONCLUSNE <br /> OTTL License#: 90-1143 EX.12-31-12 <br /> Trainee: PASS FAIL INCONCLUSIVE <br /> PASS FAIL LJINCONCLUSIVE <br /> EQUIPMENT: PETRO TITE LINE TESTER PASS FAIL INCONCLUSIVE <br />
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