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COMPLIANCE INFO_2006-2011
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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PR0231070
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COMPLIANCE INFO_2006-2011
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Last modified
2/22/2023 1:52:51 PM
Creation date
6/3/2020 9:43:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2006-2011
RECORD_ID
PR0231070
PE
2351
FACILITY_ID
FA0006439
FACILITY_NAME
COUNTRY CLUB MOBIL CIRCLE K
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231070_2575 COUNTRY CLUB_2006-2011.tif
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EHD - Public
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APR 2 8 2010 <br /> 416 2"d Street &V` <br /> ""� ; -0112 LINE & LEAK DETECTOR <br /> I 110rd — Galt,Ca 95632 rF4x., I-0116 TEST REPORT <br /> afforda@softeom',net <br /> CONTRACTOR/ENGINEER M. V. P. -- GAWFCO TEST DATE 4 / 19/ 10 <br /> SITE NAME COUNTRY CLUB 76 PHONE ( ) - <br /> SITE ADDRESS 2575 COUNTRY CLUB BLVD. CITY STOCKTON CA 95204 <br /> ® I Repair/Construction LOCATION SKETCH Show North <br /> [ j I Compliance -- — -- <br /> E] Insurance 6 s <br /> Escrow <br /> —_ 5 7 <br /> Make&Type of Pump or Dispenser DIE 2 4 <br /> RED JACKET--GILBARCO 1--7 <br /> t 3 <br /> Cover Over Lines 87 <br /> CONCRETE ZZ <br /> Approx Burial Depth 10=9 <br /> 4-6 FT. STORE <br /> Weather <br /> OVERCAST, WARM _ SHOW STREETS,BLDGS,TANKS,ISLANDS,PIPING(IF KNOWN), MPS XOR DISPENSERS <br /> ® Pressure Suction 0 <br /> ]C-alibrate <br /> LEAK DETECTOR FTA LEAK DETECTOR TEST INFORMATION0 PS1 <br /> Opening Test Leak I Element <br /> KEY TYPES No/ LD Serial Resiliency Time In Rate Holding Metering Pass/ <br /> Product Key Number Seconds ML/Min. PSI PSI Fail <br /> A LD 2000 --- — --- -- <br /> B LD 2000E _ ------ <br /> C FXI V — — — <br /> D FXI DV -- — -- <br /> E STPMLD <br /> FSTPMLD — D _ — — -- <br /> G STPMLD — E — — <br /> H STPMLD-D/E Notes: — — <br /> CONTRACTOR <br /> CERTIFICATION LINE TEST RESULTS <br /> Technician: <br /> 'Tests were made on the line systems as noted in accordance with test procedures <br /> " ' prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br /> ZANE NIMMO LINE IDENTIFICATION — NET VOLUME CHANGE PER: HOUR <br /> PETROTITE CERT.#: 91 OCTANE PASS/FAIL/INCONCLUSIVE +/-,0000 <br /> CCA: 0202112304R <br /> OTTL License#: 04-1676 PASS/FAIL/INCONCLUSIVE <br /> Trainee: <br /> Mike Fuller PASS/FAIL/INCONCLUSIVE <br /> PASS/FAIL/INCONCLUSIVE <br /> EQUIPMENT: PETRO TITE LINE TESTER <br />
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