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COMPLIANCE INFO 2001-2010
Environmental Health - Public
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PR0231906
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COMPLIANCE INFO 2001-2010
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Last modified
9/8/2021 1:08:13 PM
Creation date
11/5/2018 3:42:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2001-2010
RECORD_ID
PR0231906
PE
2361
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\K\KETTLEMAN\420\PR0231906\COMPLIANCE INFO 2001-2010.PDF
QuestysFileName
COMPLIANCE INFO 2001-2010
QuestysRecordDate
5/19/2017 11:33:18 PM
QuestysRecordID
3391364
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SWRCEt; January 2002 <br />7. <br />Test Method Developed By: <br />Test Method Used: <br />• <br />D UDC Manufacturer <br />D Other (Specify) <br />P <br />D Industry Standard <br />Page S of PS <br />Engineer <br />_--_—O Pressure _-_- -_-_ �Vacuum.--.r._.�._-Iydrostatic-_ <br />D Other (Specify) - _ �_.. <br />rest F.auinment I Ned- ; ",-. , /.... , i <br />Comments - (include information on repairs made prior to testing; and recommendedfollow-up for failed tests) <br />If the entire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an <br />asterisk(*) is "NO" or "NA", the entire UDC must be tested. (See S WRCB LG -1 G0) <br />cr <br />me ton: <br />� <br />I <br />UDC #.! f UDC # 3 f( <br />N9 Mj; '. •fi:^'-. <br />UDC # <br />. W i1 ,YS. 4.... <br />UDC Manufacturer: <br />1l,a <br />UDC # <br />UDC Material: <br />riy?n <br />c moo( <br />F of <br />11% , <br />UDC Depth; <br />3 3 <br />alr <br />Height from UDC Bottom to Top <br />� , <br />�2 <br />of Hi est Pi in Penetration: <br />o, ff �,r- 70 °' <br />Height from UDC Bottom to <br />Lowest Electrical Penetration: <br />(t " (Z, <br />f <br />i <br />� 6 <br />Condition of UDC prior to <br />test,✓t/ <br />f UDC Tested <br />ulcrir-r-Lpvo(yam,, <br />t,. ^�, k;A rrl.n..ai� a <br />bine shut down whensor <br />detects liquid (both <br />KYes D No D NA � Yes D No D NA <br />hCVI- DNo DNA <br />Yes ❑ No ❑ NA <br />and water)?'hutdownres <br />onetime <br />��akCI-JCJOh <br />programmed for fail -down?' <br />Yes ❑ No ❑ NA KYes D No D NA <br />'fes D No D NA <br />_ Yes D No DNA <br />Was fail-safe verified to be <br />o er ational?4 <br />D Yes GT No DNA Dyes ONO DNA <br />D Yes bNo DNA <br />❑ Yes 0&n DNA <br />Wait time between app�ying <br />pressure/vacuum/,Wate�and <br />starting test '.::'.. <br />e <br />r� J };rt.. •<- r frt r -t 'r cr (•"$ <br />/1 '.'r • <. c� "' <br />-r i <br />Test Start Time: <br />-4: 3 - �3' /r <br />9:`To <br />n <br />Initial ReadiLig <br />Test End Time: <br />r o 5 l ' iq <br />d_ ^0 <br />Final Readin R r <br />/ <br />, •'-j 7" rt <br />- <br />Test Duration: <br />+ . , ,, ., � <br />Change in Readin <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />[i Pass D Fail . Cr Pass D Fail <br />Pass D Fail <br />D Pass D Fail <br />Was sensor removed for testing? <br />2 -Yes D No D NA DYes D No DNA <br />01jes ONO DNA <br />D Yes D No D NA <br />Was senor properly replaced and <br />' <br />verified functional after testin ? <br />0 Yes D No D NA D Yes D No D NA <br />)DYesD No D NA <br />0 Yes D No D NA <br />Comments - (include information on repairs made prior to testing; and recommendedfollow-up for failed tests) <br />If the entire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an <br />asterisk(*) is "NO" or "NA", the entire UDC must be tested. (See S WRCB LG -1 G0) <br />
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