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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
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EHD - Public
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' SWRCB, January 2002 • • Page(, of_7) <br />7. UNDER -DISPENSER CONTAINMENT (UDC) TESTING <br />Test Method Developed By: 0 UDC Manufacturer D Industry Standard�[ Professional Engineer <br />x <br />0 Other (Specify) <br />Test Method Used: ❑ Pressure -, 4_ c D Vacuum_-,_ _ __'17 Hydrostatic <br />0 Other (Spec) <br />Test Equipment Used: '_!{!_l,urI_(L. s..,i,n LP./ <br />Equipment Resolution:— <br />UDC # % t�,a <br />UDC <br />UDC# <br />UDC# <br />[. <br />r I ; <br />UDC Manufacturer: <br />UDC Material: <br />4 /v <br />UDC Depth: <br />Height from UDC Bottom to Top <br />of Highest Piping Penetration: <br />Height from UDC Bottom to <br />Lowest Electrical Penetration: <br />Condition of UDC prior to <br />testing: <br />7 '-s-- <br />Portion of IIDC Tested' <br />l g, <br />Does turbine shut down when <br />f <br />UDC sensor detects liquid (both <br />XYes D No DNA <br />0 Yes 0� DNA <br />0 Yes ; 0 No 0 NA <br />0 Yes D No DNA <br />ater ? <br />product and water)?. <br />� <br />Turbine shutdown response time <br />rJoI /'r., <br />Is system programmed for fail- <br />Yes D No 0 NA <br />D Yes 0 No'. D NA <br />D Yes pNo DNA <br />0 Yes D No D NA <br />safe shutdown?* <br />Was fail-safe verified to be <br />0 Yes PNo DNA <br />D Yes D No 0 NA <br />0 Yes ❑ No 0 NA <br />0 Yes 11 No 0 NA <br />operational?* <br />i <br />Wait time between applymg <br />/ <br />pressure/vacu qps d <br />starting test <br />I <br />Test Start Time: <br />Initial Reading O: <br />Test End Time: <br />z Y LJ <br />Final Reading (RF): <br />Test Duration: <br />3 n r.r r. ,,., a `" <br />i k <br />Change in Reading (RF -R,): <br />tj n C Ic e-. • <br />/ 1 <br />f <br />% <br />Pass/Fail Threshold or Criteria: <br />, pr <br />Test Result: <br />Q Pass 0 Fail <br />q Pass D Fail - <br />11, Pass ❑ Fail <br />r0 Pass D trail <br />Was sensor removed for testing? <br />Yes 0 No 0 NA <br />O Yes 0 No D N <br />0. es D No DNA <br />❑ Yes 0 No dNA <br />Was sensor properly replaced and <br />k� es D No ❑ NA <br />Yes ❑ No ❑ NA1 <br />Yes ❑ No DNA <br />0 Yes 0 No 0 NA <br />verified functional after testing? <br />1 <br />Comments — (include information on repairs madeprior to testing,and recommended ollow-u or ailed tests <br />�l �� ,� ,� !- ",..r y�'i q . u. 'r' '1i)tYr- '-1/nc' r-' a• ) !�i),t S r t/�; I, <br />r <br />i <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 IJDC must be tested. (See SWRCB LG -160) <br />
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