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COMPLIANCE INFO_2009-2013
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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PR0232494
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COMPLIANCE INFO_2009-2013
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Last modified
11/14/2023 12:52:58 PM
Creation date
6/3/2020 9:57:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2009-2013
RECORD_ID
PR0232494
PE
2361
FACILITY_ID
FA0002602
FACILITY_NAME
KAISER PERMANENTE
STREET_NUMBER
7373
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09416023
CURRENT_STATUS
01
SITE_LOCATION
7373 WEST LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232494_7373 WEST_2009-2013.tif
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EHD - Public
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0 <br /> SWRCB,January 2002 Page -5—of r? <br /> Fest 7. UNDER-DISPENSER CONTAINMENT DC TESTING <br /> Method Developed By: 0 UDC Manufacturer 0 Industry Standard 0 Professional Engineer <br /> 0 Other(Specify) <br /> Test*thod Used: 0 Pressure 11 Vacuum 0 Hydrostatic <br /> 0 Other(Specify) <br /> Test Equipm t Used: Equipment Resolution: <br /> 7 <br /> LnS UDC# UDC# UDC# UDC# <br /> UDC Manufacturer: <br /> UDC Material: <br /> UDC Depth: Z <br /> Height from UDC Bottom to 1,61z, <br /> of Highest Piping Penetration: <br /> Height from UDC Bottom to <br /> Lowest Electrical Penetration: <br /> Condition of UDC prior to <br /> testin2: <br /> Portion of UDC Tested' <br /> Does turbine shut down when <br /> UDC sensor detects liquid(both 0 Yes 0 No 0 NlX, 0 D No 0 NA 0 Yes 0 No 0 NA 0 Yes D No 0 NA <br /> product and water?0 <br /> Turbine shutdown response time <br /> Is system programmed for fail- <br /> safe shutdown?* 0 Yes 0 No 0 0 Yes ®,No' C1 NA 0 Yes 0 No 0 NA 0 Yes 0 No 0 NA <br /> Was fail-safe verified to be 0 Yes 0 ❑NA 0 Yes 0 No NA 0 Yes 0 No 0 NA 0 Yes 0 No 0 NA <br /> operational?' <br /> Wait time between applying <br /> pressure/vacuum/water and f X <br /> starting test <br /> Test Start Time: <br /> Initial Reading(Ri): <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: z <br /> Change in Read' g'(RF-RT): <br /> Pass/Fail Thrershold or Criteria: <br /> Test ResiAt: 0 Pass -0 Fail 0 Pass 0 Fail 0 Pass D Fail 0 ss 0 Fail <br /> Was sor removed for testing? OYes DNo DNA 0Yes DNo DNA 0 Yes 0 No 0 NA 0 Yes o 0 NA <br /> W*sensor properly replaced and <br /> Dyes ONo DNA DYes ONo DNA] DYes DNo DNA F Yes n NoNAverified functional after testmL? <br /> Comments—(include information on rEealrs made prior to testing, and recommended follow-up for failed tests) <br /> yL <br /> If the entire depth of the UDC is not tested, specify how much was tested. If the answer to M of the questions indicated with an <br /> asterisk(*)is"NO"or"NA",the entire UDC must be tested. (See SWRCB LG-160) <br />
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