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COMPLIANCE INFO 1987 - 2005
Environmental Health - Public
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EHD Program Facility Records by Street Name
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6421
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2300 - Underground Storage Tank Program
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PR0231706
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COMPLIANCE INFO 1987 - 2005
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Last modified
6/11/2019 9:52:01 AM
Creation date
4/10/2019 1:52:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1987 - 2005
RECORD_ID
PR0231706
PE
2361
FACILITY_ID
FA0000485
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95242
APN
05532024
CURRENT_STATUS
01
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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KBlackwell
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EHD - Public
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SO#/OSGiZ Owi.er: ��, y,� � Site# �o�o <br /> MONITOR WELLS <br /> Well Number 1 2 3 4 5 6 7 8 9 10 11 12' <br /> Well Depth <br /> Depth to Water <br /> Product Detected <br /> AMOUNT in inches <br /> Standard Symbols for diagram below. F Fill V Vapor Recovery <br /> /s V.R. w / Ball Float OM Monitor Well Observation Well <br /> (Outside Tank Bed Area) (Inside Tank Bed Area) <br /> © Ball Float GO Tank Gauge O Vent <br /> MD Manway ❑I Iron Cross M Turbine <br /> Location Diagram—Include the.Vapor Recovery System. <br /> H . 0 . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . Cl �". CJ r El <br /> 7 ' <br /> d <br /> ✓h1Y2 U i Scc�'riarl O �/}L✓i <br /> ✓r4�✓� VAI ilv {� <br /> p C� • p c> O <br /> I <br /> I <br /> p Fw2 p vlvt O F/Yt p p FikL . . <br /> SLIT) ��JS �U�• 12J�' f'/656L <br /> ICK IZK. 2K �2 . lZ. . <br /> avoo o <br /> Vapor Recovery System & Vents were tested with which tank? <br /> Parts and Labor used <br /> General Comments <br /> When OWNER or loca! regi-ria`:—ons req,-,Ire irr.mcd;ate reports of system failure-Complete the following: <br /> REPORTED NAME DATE TIME <br /> TO: <br /> Phone# OWNER or Regulatory Agency FILE NUMBER <br /> Print Certified Testers Name Vacutec Ce cation Number <br /> DIAV , <br /> Certified Testers Signature Date Testing Completed <br /> ,L Na v q3 <br /> FanmTarftU*9 WW <br />
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