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COMPLIANCE INFO_2007-2008
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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PR0231331
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COMPLIANCE INFO_2007-2008
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Last modified
6/20/2023 10:36:46 AM
Creation date
6/3/2020 9:43:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2007-2008
RECORD_ID
PR0231331
PE
2351
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231331_975 S FAIRMONT_2007-2008.tif
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EHD - Public
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• • <br /> SWRCB, January 2002 Page of <br /> S. FILL RISER CONTAINMENT SUMP TESTING <br /> Facili is Not Equipped With Fill Riser Containment Sum s <br /> Fill Riser Containment Sumps are Present, but were Not Tested ❑ <br /> Test Method Developed By: r Sump Manufacturer t-; Industry Standard 7 Professional Engineer <br /> I'Other(,Spec) <br /> Test Method lJsed: �j Pressure ❑ Vacuum ❑ Hydrostatic <br /> L]Other(.Specfy) <br /> Test Equipment Used:._ Equipment Resolutio ' <br /> Fill Sum # Fill Sum # Fill Sum # . ' Fill Sum # <br /> Sum Diameter: _ � <br /> Sump Depth: <br /> Height from Tank Top to Top of ; <br /> Highest Piping Penetration: <br /> Height from Tank Top to Lowest <br /> Electrical Penetration: <br /> Condition of sump prior to ` <br /> testing: �. <br /> Portion of Sump Tested <br /> Sump Material: <br /> Wait time between applying <br /> pressure/vacuum/water and +, <br /> starting test: , <br /> Test Start Time: <br /> Initial Reading(111): <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: <br /> Change in Reading(RF-R,): <br /> Pass/Fail Threshold or Cr' ria: <br /> Test Result: --d—pass ❑ Fail ❑ Pass ❑Fail ❑ Pass ❑ Fail "'❑" Pass ❑ Fail <br /> Is there a sensor i;,tKe sump? ❑ Yes ❑No ❑Yes ❑No ❑Yes ❑No ❑ Yes ❑No <br /> Does the sensor arm when ," <br /> either produc r water is ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No, ❑NA <br /> detected? <br /> Was se or removed for testing? ❑ Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA <br /> Was,5,ensor properly replaced and ❑Yes ❑No ❑NA ❑Yes ❑No [INA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA <br /> verified functional after testing? <br /> Comments—(include information on repairs made prior to testing and recommended follow up for failed tests) <br />
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