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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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PR0231692
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COMPLIANCE INFO_2020
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Last modified
12/22/2020 9:25:12 AM
Creation date
6/11/2020 3:51:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
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
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SJGOV\kblackwell
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EHD - Public
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3. PIPING SUMP TESTING <br /> Company Name: B.Z. Service Station Maintenance <br /> Company Address: 1041 Triangle Ct.,West Sacramento,CA 95605 <br /> Credentials: ®CSLB Licensed Contractor ❑ SWRCB Licensed Tank Tester <br /> License Type: ICC License Number: 433159 _ I <br /> TURBINE/PRODUCT PIPING SUMPS ❑ VENT/TRANSITION SUMPS ❑ <br /> k <br /> Equipment Used: INCON TS-STS Equipment Resolution:0.0001 <br /> Sump# Sump# Sump# Sump# <br /> Portion of Sump Tested' _ <br /> Does turbine shut down when <br /> sump sensor detects liquid(both ❑ Yes❑No❑NA ❑Yes❑No❑NA ❑Yes❑No❑NA ❑Yes❑No[—] <br /> NA <br /> product and water)?' _ <br /> Turbine shutdown response time <br /> Is system programmed for fail-safe Q Yes❑No❑NA Q Yes Q No❑NA ❑Yes❑No❑NA ❑Yes❑No❑NA l <br /> shutdown?' <br /> Was fail-safe verified to be Q Yes❑No❑NA ❑Yes Q No Q NA ❑Yes❑No❑NA Q Yes❑No❑NA <br /> operational?* <br /> Wait time between applying <br /> pressure/vacuum/water and starting <br /> test: <br /> Test Start Time: <br /> Initial Reading(Ri): <br /> "fest End Time: <br /> Final Reading(RF): <br /> Test Duration: 15 MIN 15 MIN 15 MIN 15 MIN <br /> Change in Reading(RF-Ri): <br /> Pass/Fail Threshold or Criteria: 0.002 0.002 0.002 0.002 <br /> Test Result: ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass Q Fail ❑ Pass ❑ Fail <br /> Was sensor removed for testing? ❑Yes❑No❑NA Q Yes Q No❑NA ❑Yes Q No❑NA ❑ Yes❑No❑ NA <br /> Was sensor properly replaced and Q Yes❑No E]NA ❑Yes[I No El NA El Yes❑No E]NA El Yes E]No E]NA <br /> verified functional after testing? <br />
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