Laserfiche WebLink
RECEIVED <br />FEB 0 3 2017 <br />ENVIRONMENTAL HEALTH <br />1. FACILITY INFORMATION DEPARTMENT <br />Facility Name: USA/Tesoro # 68152 Date of Testing: 1/5/17 <br />Facility Address: 401 W. Kettleman Ln. — Lodi CA 95240 <br />Facility Contact: Patricia Moreno Phone: (209) 368-8787 <br />Date Local Agency Was Notified of Testing: 12/27il6 5B989 — 3yr. Compliance Test <br />Name of Local Agency Inspector {if present during testing): <br />Manufacturer Trainin <br />Manufacturer Com gonent(s) DateTraining Expire <br />Available upon request H <br />Component: <br />87 Tank Annular <br />91 Tank Annular <br />87 Secondary Product <br />91 Secondary Product <br />87 Turbine Sump <br />91 Turbine Sump <br />UDC 1/2 <br />UDC 3/4 <br />UDC 516 <br />UDC 7/8 <br />87 Fill Bucket <br />91 Fill Bucket <br />87 Vapor Bucket <br />91 Vapor Bucket <br />Component: Pass Fail Not Repairs <br />Tested Made � <br />If hydrostatic testing was performed, describe what was done with the water after completion of tests: <br />Used pump test truck <br />