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COMPLIANCE INFO 2009 - 2013
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231706
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COMPLIANCE INFO 2009 - 2013
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Last modified
6/11/2019 11:57:34 AM
Creation date
4/10/2019 3:28:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2009 - 2013
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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JAN.10.2013 <br />9:24AM CORr1ELI1JS & COMPANY <br />Spill Bucket <br />1. <br />Test Method Use; x Hydrostatic <br />ieSt Equipment Used: Pump <br />Identify Spill Bucket (By Tank—� L SUPER <br />Number, Stored Product) <br />NO. 837" P. 4 <br />Report Form <br />Vacuum Otlier <br />Equipment Resolution: <br />IZ. UNLEADED 3- UNLEADED 4. DIESEL <br />MASTER I SLAVE <br />Bucket Ynstalltion Type. Direct Bury Direct Bury <br />Direct Bury Direct Bury <br />XContained in Sump X Contained in Sump )CContuined 'n S <br />Bucket Diameter: <br />' ump <br />12" <br />XContained in Sump <br />Bucket Depth: <br />12" 12" <br />17.50" <br />I �, <br />Fait time between applying <br />17.75" <br />10 NEIN <br />17.25" <br />vscuum/water and start of test: <br />10 MIN 10 WN <br />10 MIN <br />Test Start Time (Ti)-. <br />9:19 AM 9:15 AM <br />Initial Reading (R1); <br />9:15 AM <br />9:15 Alva <br />Test End Titne (Tf <br />16.5U" I6.25" 16.75" <br />16,25" <br />.- <br />Final Reading 074); <br />10;15 AM 10:15 AM 10:15 AM <br />I0:15AM <br />'fest Duration (Tf — T1): <br />16,30" 4,50" 16.75" <br />16,15" <br />Chango in Reading (Rf-R]): <br />1 HR 1 14R IHR <br />IHR <br />0 11,75" 0 <br />0 <br />Pass/Fail Threshold or Criteria: <br />.025" 025" <br />Test .Results: <br />OZS" <br />X Pass Fail Pass X Fail X,Pass 1~'aii <br />.025" <br />C'o tett • - in de in . mation <br />Xl'ass at <br />on airs de r1or to t s 'n a re imme ded f Ilow_ . for failed t sts <br />Certifi ation of Technician Responsible for Conducting This Testing <br />I hereby certify that all the in <br />Technician's Signature: <br />a Sn this report is true, and in full compllanee with legal requirements. <br />Dote• 09p 12 <br />t�f <br />
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