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COMPLIANCE INFO 2003 - 2008
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231706
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COMPLIANCE INFO 2003 - 2008
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Last modified
6/11/2019 11:42:03 AM
Creation date
4/10/2019 2:41:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2003 - 2008
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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EHD - Public
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SWRCB, January 2002 <br />7. UNDER-DISPFNSF.R rnNTA NMrlvT rrrni-1 TVemnv.� <br />Page 7 of <br />1L'U1it\V <br />Test Method Developed By: ❑ UDC Manufacturer ❑ Industry Standard rofessional Engineer <br />❑ Other (Spec) <br />Test Method Used: ❑ Pressure ❑ Vacuum P{ hydrostatic <br />❑ Other (Spec) <br />Test Equipment Used: C,, /j,0 - Le" --e L (—' ,,,,._�,�� , j-, �1� "'. _(��4, Equipment Resolution: <br />,odd <br />J ` X- � <br />==41141 <br />a UDC # 9 sv UDC # 6l /Z 1VDC # UDC # <br />Imm <br />UDC Manufacturer: <br />UDC Material: <br />o a <br />©1 <br />UDC Depth: <br />Height from UDC Bottom to Top <br />of Highest Piping Penetration: <br />14 <br />Height from UDC Bottom to <br />Lowest Electrical Penetration: <br />?n ra 2 l ��iH+ <br />eAa-+ cz, �• : � <br />Condition of UDC prior to <br />;,•,.<,�i �,N�,w., <br />testing: <br />t' ,1�; ° c.. <br />2) Y <br />Portion of UDC Tested <br />�i ��r�vi� �� �� <br />w�„� .y, tA:+t. ,+� �• <br />Does turbine shut down when <br />f <br />UDC sensor detects liquid (both <br />es ❑ No ❑ NA <br />es ❑ No El NA <br />❑ Y No 1) NA <br />❑ Ye Q'No ❑ NA <br />roduct and water)?� <br />i <br />} <br />Turbine shutdown response time <br />Is system programmed for fail- <br />safe shutdown?` <br />Yes ❑ No ❑ NA <br />_ 3 Yes ❑ No ❑ NA <br />❑ Yes No ❑ NA <br />❑ Yes p No ❑ NA <br />Was fail-safe verified to be <br />o erational?' <br />i <br />Yes ❑ No ❑ NA <br />,E�Ves ❑ No ❑ NA <br />❑ Yes p No ❑ NA <br />❑ Yes No ❑ NA <br />Wait time between applying <br />pressure/vacu water d <br />starting test <br />/o (, <br />!p r> ,, :.,.o •� S <br />Test Start Time: <br />to _' 76 <br />Initial Reading j): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />nrr��, �a, 5 <br />-'a�se.•.�r d . <br />Chane in Reading (RF -R,): <br />NO &4w— <br />Pass/Fail Threshold or Criteria:9C0JYesONo <br />Test Result: <br />Pass ❑ Fail <br />Pass ❑ Fail <br />ail <br />❑ Pass d FailWas <br />sensor removed for tesring7 <br />es ❑ No ❑NA <br />s 0 No ❑ NA <br />NA <br />❑ Yes ❑No ❑NA <br />Was sensor properly replaced and <br />functional after testin ?'es <br />❑ No ❑ NA <br />.L'1 ��'es ❑ No ❑ NA <br />NA <br />,verified <br />❑ Yes 0 No DNA <br />Comments — (include information on repairs made prior to testing and recommended follow-up for failed tests) <br />' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to as of the questions indicated with an <br />asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG -160) <br />
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