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COMPLIANCE INFO_2001-2009
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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PR0231692
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COMPLIANCE INFO_2001-2009
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Last modified
12/28/2023 11:29:54 AM
Creation date
6/3/2020 9:51:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2001-2009
RECORD_ID
PR0231692
PE
2361
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231692_444 W MOSSDALE_2001-2009.tif
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EHD - Public
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SWRCB, January 2002 <br />Page [ of <br />Test Method Developed By: 0 UDC Manufacturer 0 Industry Standard rofessional Engineer <br />0 Other (Sped) <br />Test Method Used: 0 Pressure 0 Vacuum Hydrostatic <br />0 Other (Spec) <br />Test Equipment Used: C4411,j ell Lew ,, z,'rv,,J # 11, Equipment Resolution: , o a x, <br />UDC # 7 , /t� UDC UDC # :UDC # <br />UDC Manufacturer: e d a : r 6W a r <br />UDC Material: Zle <br />UDC Depth: <� <br />f <br />Height from UDC Bottom to Top <br />of Hi est Piping Penetration: 1- 2 <br />Height from UDC Bottom to <br />Lowest Electrical Penetration: <br />Condition of UDC prior to <br />Y <br />g <br />i <br />testin <br />Portion of UDC Tested 1104 Pr LAA,�.C, 1 q>' W,a-i-,k- ( <br />Does turbine shut down when <br />UDC sensor detects liquid (both 0 Yes 0 No ❑ NA GIVes 0 No 0 NA <br />0 Yes 0 No ❑ NA <br />❑ Yes 014o ❑ NA <br />induct and water ?° CV <br />Turbine shutdown re§Lonse time 1,)e)f Clu e k OA vTT-T Tl <br />Is system programmed for fail -f <br />Yes 0 No ❑ NAes 0 No C1 NA <br />safe shutdown?® <br />❑ Yes C'1 N ❑ NA <br />e <br />0 Yes UNo 0 NA <br />Was fail-safe verified to be ❑yesNo ❑ NA 0 Yes o ❑ NA <br />11Yes ❑ J o 11NA <br />❑ Yea' No DNA <br />operational?* <br />Wait time between applying <br />t i <br />pressureIvaco wa" err d <br />,¢ <br />® <br />starting test <br />Test Start Time: <br />Initial Reading LR,):� �tiL'� r L c'4 <br />Test End Time: <br />Final Reading (EF: J $ c t apt, Er,c. t ,, Lc - <br />—Test <br />Test Duration: <br />Change in Reading -R a j c,I , . c i c <br />' <br />Pass/Fail Threshold or Criteria: 00 s 6 <br />l <br />t <br />Test Result: Pass ❑ Fail 3a Pass ❑ Fall <br />Qf Pass ❑ Falk❑ <br />Pass ❑ 0ail <br />Was sensor removed for testing? NrYes 0 No 0 NA XYes 0 No 0 NA <br />❑= es- 0 No ❑ N <br />b Yes 0 No DNA <br />Was sensor properly replaced and <br />verified functional after testing? 7Yes 0 No 0 NA es ❑ No 0 NA <br />Yes 0 No 0 NA <br />0 Yes 0 No 0 NA <br />Comments — (include information on repairs made prior to tesl!n% and recommended follow-up for failed tests) <br />' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to my of the questions indicated with an <br />asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB 1,G-160) <br />
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