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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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MOSSDALE
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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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Entry Properties
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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.Lest I"LlUiP111C111 Used: INCON TS-STS EqUil)fflellt RCSOIL16011: 0.0001 <br /> UDC # U 1)C# UDC# UDC <br /> Portion of-UDC Tested' <br /> Does turbine shut down when <br /> UDC sensor detects liquid(both El Yes E] No 0 NA El Yes 0 No E]NA F-1 Yes E No[:1 NA ❑ Yes F-1 No❑NA <br /> product and water)?* <br /> Turbine shutdown response time <br /> Is system programmed for fail- <br /> 9. E]Yes No F-1 NA ❑Yes[:] No[_1 ❑NA Yes[:1 No[:]NA ❑Yes❑No❑NA <br /> safe shutdown. <br /> Was fail-safe verified to be Yes❑ No E] NA [:1 Yes[I No[I NA ❑Yes[:1 No C:1 NA ❑Yes❑No❑NA <br /> oper tional?' ❑ <br /> Wait time between applying <br /> pressure/vacuum/water and <br /> starting test <br /> Test Start Time: <br /> Initial Reading(Ri): <br /> Test 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: 0 Pass El Fail El Pass [I Fail 0 Pass [I Fail Ll Pass El Fail <br /> Was sensor removed for testing? Q Yes E]No[:]NA El Yes[:]No E]NA E] Yes[]No[—]NA [:]Yes❑No E]NA <br /> Was sensor properly replaced and Yes E] No E]NA El Yes[:1 No[:]NA ❑ Yes El No El NA E]Yes❑No[_] NA <br /> a <br /> verified functional after testing? <br /> Comments—(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> N/A <br /> RECEIVED <br /> SFP 0 4 21171 <br /> E.NVIRONNIENTAL HEALTH <br /> m.'i,ARTNIENT <br />
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