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COMPLIANCE INFO_2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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2300 - Underground Storage Tank Program
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PR0231346
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COMPLIANCE INFO_2019
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Last modified
11/21/2022 10:36:02 AM
Creation date
3/20/2019 11:10:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0231346
PE
2361
FACILITY_ID
FA0003603
FACILITY_NAME
TESORO (SPEEDWAY XP) 68152
STREET_NUMBER
401
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04513019
CURRENT_STATUS
01
SITE_LOCATION
401 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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UNDERGROUND STORAGE TANK <br />SECONDARY CONTAINMENT TESTING REPORT FORM (Page 3 of 6) <br />IX. REMOTE FILL PIPING CONTAINMENT TESTING INFORMATION <br />Manufacturer FIdentify Tank ID from Section III for each Manufacturer <br />A❑ <br />B❑ I C❑ <br />D <br />A❑ <br />B I C❑ <br />I D❑ <br />Test Method Used: <br />❑ Manufacturer Guidelines (Specify): <br />❑ Industry Code or Engineering Standard (Specify): <br />❑ Engineered Method (Specify): <br />Attach the testing procedures and all documentation required to determine the results. <br /># of Attached Pages <br />Remote Fill Piping Containment Testing Training and Certifications (List applicable certifications.) <br />Expiration Date <br />Interstitial Communication Verification Method Used: <br />X. COMMENTS <br />Provide any additional comments here. <br />N/A <br />XI. VENT PIPING CONTAINMENT TESTING INFORMATION <br />Manufacturer Identify Tank ID from Section III for each Manufacturer <br />A❑ <br />B❑ <br />I C❑ <br />D❑ <br />A❑ <br />B❑ <br />I C❑ <br />D❑ <br />Test Method Used: <br />❑ Manufacturer Guidelines (Specify): <br />❑ Industry Code or Engineering Standard (Specify): <br />❑ Engineered Method (Specify): <br />Attach the testing procedures and all documentation required to determine the results. <br /># of Attached Pages <br />Vent Piping Containment Testing Training and Certifications (List applicable certifications.) <br />Expiration Date <br />Interstitial Communication Verification Method Used: <br />XII. COMMENTS <br />Provide any additional comments here. <br />Single wall - N/A <br />ID =Identification <br />
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