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COMPLIANCE INFO_2002-2009
Environmental Health - Public
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2300 - Underground Storage Tank Program
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PR0231069
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COMPLIANCE INFO_2002-2009
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Last modified
2/27/2023 4:51:25 PM
Creation date
6/3/2020 9:44:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2002-2009
RECORD_ID
PR0231069
PE
2361
FACILITY_ID
FA0001909
FACILITY_NAME
STOP N SHOP
STREET_NUMBER
1856
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
123-191-02
CURRENT_STATUS
01
SITE_LOCATION
1856 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231069_1856 W COUNTRY CLUB_2002-2009.tif
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EHD - Public
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416 2nd Street Galt CA 9560 Spill Bucket <br /> AFFORDA-TE$ (209) 744-0112 (209) 7.44-0116 FAX Test Report <br /> " TEST DATE <br /> SITE NAME PHONE ( ) <br /> d � <br /> ADDRESS � aC`,,, CONTACT: <br /> Inspector: r--P (" Present c/ Not Present <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: 3°Hydrostatic D Vacuum ❑Other <br /> Test Equipment Used: p Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1 23 4 <br /> Number, Stored Product, etc. ��(�� �� NJ <br /> Bucket Installation Type: Direct Bury Direct Bury ❑Direct Bury ❑Direct Bury <br /> ❑Contained in Sump ❑Contained in Sump ❑Contained in Su ❑Contained in Sum <br /> Bucket Diameter: 1 .2 <br /> Bucket Depth: <br /> Wait time between applying <br /> vacuum/water and start of test: <br /> Test Start Time(Ti): CJJ bc) <br /> Initial Reading(RI): } <br /> ® Test End Time(TF): (; <br /> Final Reading(RF): <br /> Test Duration(TF—Tj): ,y , <br /> Change in Reading(RF-RO: - <br /> Pass/Fail Threshold or <br /> Criteria: <br /> Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> Test Water: ETaken with tester [:]Lefton site <br /> I hereby certify that all the.information contained in this report is true, <br /> accurate, and in full compliance with legal requirements. Technician:" Lyle D. Nimmo <br /> ICC#: 5249115-UT <br /> Signature: OTTL#: 97-1143 <br />
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