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COMPLIANCE INFO_2020
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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PR0231470
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
6/11/2020 10:38:55 AM
Creation date
6/8/2020 10:07:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231470
PE
2361
FACILITY_ID
FA0003911
FACILITY_NAME
VAN DE POL ENTERPRISES INC
STREET_NUMBER
816
Direction
E
STREET_NAME
FRONTAGE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
26102010
CURRENT_STATUS
01
SITE_LOCATION
816 E FRONTAGE RD
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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KBlackwell
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EHD - Public
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T MIA <br /> Ll mij <br /> TP-201 . 6C Or EVR Liquid Removal Test <br /> Liquid Removal Rate Report Form <br /> rSiA <br /> t Number: N4564 4 Test Company: Donlee Pump Company <br /> ame : Van De <br /> Po <br /> Enterprises , Inc. Technician: Mario Romero <br /> ddress: 816 S . Frontage Rd. Certification Number: Expiration Date: <br /> Ripon Zip : 95366 District: SJV : 0346 <br /> Date/Time of Test: 9-I I - 19 9 : 00 VST (if applicable) : 3001018737 <br /> FIFFIF <br /> TEST INFORMATION <br /> Phase II vapor recovery system executive order: ElG-70-52 (Pre-Phase H EVR balance for AST & UST) X VR-203/204 (VST Phase II EVR balance) <br /> EVR Short G jdi <br /> Dispensing Wi Wr ' W1732 <br /> Nozzle Fuel Version xx Rate Pass ! Fail <br /> Volume of GagoT <br /> Gas introduced Gas <br /> Number Grade Gas added to hose Gallon, e ��� after dispensing s drained ( 150 — 175 ml) dispensed T di150 — 175 ml) recovered m hose ml} <br /> 1 87 150 7 .504 0 :75 6 . 0 150 130 20PASS <br /> 2 87 ISQ 7 .503 Q : 64 6 .0 150 130 11 <br /> 20PASS <br /> I declare, under penalty of perjury under the laws of the state of California that based on information and belief formed after reasonable inquiry, the <br /> statements and information provided in this ocument are true, accurate, and complete. <br /> Signature of Technician: F, Date: <br /> 1 <br /> ** NOTE: For EVR systems — Prior to the Leak Decay Test, if the liquid drained from the hose is <25 ml, record the amount in the EVR short - <br /> i <br /> version column, mark the test as pass, and no further testing is required . �_ <br /> G_ <br /> IF w <br /> C: <br /> Z <br /> IF <br /> o <br /> r <br /> ver. 1 . 5 - 0S .'_0. 14 <br />
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