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COMPLIANCE INFO_1991-2008
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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PR0232519
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COMPLIANCE INFO_1991-2008
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Last modified
9/6/2024 11:37:26 AM
Creation date
6/3/2020 9:57:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1991-2008
RECORD_ID
PR0232519
PE
2361
FACILITY_ID
FA0000483
FACILITY_NAME
BILLS 76
STREET_NUMBER
633
Direction
E
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
APN
04321055
CURRENT_STATUS
01
SITE_LOCATION
633 E VICTOR RD STE A
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232519_633 E VICTOR_1991-2008.tif
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EHD - Public
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AFFORDA-TE$T 416 2nd Street Galt CA 95632 Spill Bucket <br /> (209) 744-0112 (209) 744-0116 FAX <br /> Test Report <br /> __7TEST DATE 14 <br /> SITE NAME 131 L-iIs `• b PHONE ( 2_CF1 ) 3tp _ 11715 <br /> ADDRESS t.,33 r , CONTACT: g a <br /> Inspector: Sqt4J o Qu'&I Co -7`7 Present / Not Present E] <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: XHydrostatic ❑Vacuum ❑Other <br /> Test Equipment.Used: —7AP Q Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1 2 3 4 <br /> Number,Stored Product, etc. <br /> (Direct Bury K Direct B Direct B ❑Direct <br /> Bucket Installation Type: �' �. Bury Bury <br /> ❑Contained in Sump ❑Contained in Sump ❑Contained in Sump ❑Contained in S <br /> ump <br /> Bucket Diameter: <br /> Bucket Depth: 14 '/7— 1 z IH <br /> Wait time between applying _ <br /> vacuum/water and start of test: <br /> Test Start Time(Ti): 1,5+5 1345 1 '3 <br /> Initial Reading(R0: <br /> Test End Time(TF): 1445 <br /> Final Reading(RF): f 1 3 ca 3 t t z <br /> Test Duration(TF—TI): <br /> Change in Reading(RF-N: <br /> Pass/Fail Threshold or <br /> Criteria: <br /> MMO <br /> Comments—(include informati non repairs made prior to testing and recommended ollow-up for failed tests) <br /> Test Water: ®Taken with tester F-1 Left on site <br /> 1 hereby certify that all the information contained in this report is true, <br /> accurate, and in full compliance with legal requirements. Technician:,, Zane A. Nimmo <br /> ICC#: 5263322-UT <br /> Signature: OTTL#: 04-1676 <br /> J <br />
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