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COMPLIANCE INFO 1994 - 2010
Environmental Health - Public
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EHD Program Facility Records by Street Name
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CHEROKEE
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2300 - Underground Storage Tank Program
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PR0231841
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COMPLIANCE INFO 1994 - 2010
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Last modified
7/12/2019 5:29:19 PM
Creation date
7/12/2019 2:17:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1994 - 2010
RECORD_ID
PR0231841
PE
2361
FACILITY_ID
FA0000556
FACILITY_NAME
CHEROKEE LANE SERVICE STATION*
STREET_NUMBER
900
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04742007
CURRENT_STATUS
01
SITE_LOCATION
900 S CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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KBlackwell
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EHD - Public
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SWRCB, January 2002 <br />Test Method Developed By: <br />Test Method Used: <br />Test Equipment Used: <br />Page <br />6. PIPING SUMP TESTING <br />Sump Manufacturer C Industry Standard �'_ Professional Engineer <br />Other (Specify) <br />Pressure G Vacuum Hydrostatic <br />Other (SpeciA) <br />Equipment Resolution: <br />of ' <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Ifthe entire depth of the sump is not tested, specify how much was tested. If the answer to its of the questions indicated with an <br />asterisk (") is "NO" or” N A", the entire sump must be tested, (See SWRCB LG -160) <br />Sump # <br />Sump #_ <br />Sump # <br />Sump # <br />Sump Diameter: <br />;7 r, <br />tf.f <br />Sump Depth: <br />E 2. <br />Sump Material: <br />.. <br />Height from Tank Top to Top of <br />Highest Piping Penetration: <br /><' <br />Height from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to testing: <br />Portion of Sump Tested' <br />V)0 <br />Does turbine shut down when <br />sump sensor detects liquid (both <br />`Oes ❑ No ❑ NA <br />'Yes ❑ No ❑ NA <br />0 Yes <br />C No G NA <br />Ll Yes G No <br />G NA <br />product and water)?$ <br />Turbine shutdown response timeIs <br />a ,+ •'r ;' <br />, _ >t. f ` <br />; . <br />/ <br />system rogrammed for fail-safe <br />I <br />shutdownp <br />les G No C1NA <br />Qles C No CNA <br />,g -Yes <br />G No G NA <br />0 Yes h No <br />0 NA <br />Was fail-safe verified to be <br />operational?* <br />❑ Yes P'No ❑ NA <br />G Yes O No G NA <br />G Yes <br />D No ❑ NA <br />❑Yes :❑ No <br />G NA <br />Wait time betwee .ap Ing <br />pressure/vacuu twat x d starting <br />test: <br />16 ;..,.,: <br />l� 1-� rL„r.0 / �, <br />%LJ %Y1�'t•i„ <br />./. ; <br />�n r-; <br />Test Start Time: <br />Initial Reading (R,): <br />Test End Time: <br />Final Reading (RF): <br />'rest Duration: <br />Change in Reading (RF -R,): <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />0' Pass ❑ Fail <br />4 D'Pass ❑ Fail <br />Z Pass ❑ Fail <br />0 Pass ❑ Fail <br />Was sensor removed for testing? -F''-Yes <br />C No NA i�:Yes l No ij NA �i� Yes <br />,� No NA <br />Yrrs C No <br />G NA <br />Was sensor properly replaced and <br />>\Yes i� No <br />verified functional after testing? <br />!.1 NA .-PFS�Yes <br />i; No I : NA :%Yes <br />:� No != NA <br />;3 �'es G No <br />NA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Ifthe entire depth of the sump is not tested, specify how much was tested. If the answer to its of the questions indicated with an <br />asterisk (") is "NO" or” N A", the entire sump must be tested, (See SWRCB LG -160) <br />
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