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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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P
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PICCOLI
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1990
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2300 - Underground Storage Tank Program
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PR0231820
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COMPLIANCE INFO_2020
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Last modified
3/8/2021 9:27:37 AM
Creation date
6/18/2020 9:46:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231820
PE
2361
FACILITY_ID
FA0003826
FACILITY_NAME
Supervalu
STREET_NUMBER
1990
Direction
N
STREET_NAME
PICCOLI
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10121001
CURRENT_STATUS
01
SITE_LOCATION
1990 N PICCOLI RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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UNDERGROUND STORAGE TANK <br />SECONDARY CONTAINMENT 'TESTING REPORT FORM (Page 6 of 6) <br />XXI. UNDER-DISPENSER CONTAINMENT TESTING INFORMATION <br />Manufacturer(s) Identify UDC ID from Section III for each Manufacturer <br />N/A <br />1 ITIc 2 n 3 D 4 0 5 1-1 6 [-I <br />8 fl 90 10 <br />40 <br />I- 11 • <br />5 <br />12 <br />6 <br />E <br />0 20 30 <br />70 8Li 9 0 loU 11 0 12 <br />Test Method Used: <br />Hydrostatic <br />111 Manufacturer Guidelines (Specify): Franklin Fueling INCON TS - STS <br />0 I nducitry COGIC: or Enginccring <br />El Engineered Method (Specify): <br />Standard (Spccify): <br />Attach the testing procedures and all documentation required to determine the results. <br /># of Attached Pages <br />2 <br />UDC Testing Training and Certifications (List applicable certifications.) Expiration Date <br />Franklin Fueling INCON TS - STS - 1032363709 09/29/2019 <br />XXII. COMMENTS <br />Provide any additional comments here. <br />Diesel Dispenser - <br />11:20am to 11:35am, 4.9408" / 4.9403" - 0.0005 Difference - PASSED <br />11:35am to 11:50am, 4.9403" / 4.9402" - 0.0001 Difference - PASSED <br />If the facility has more components than this form accommodates, additional copies of these pages may be attached. <br />UDC = Under-Dispenser Containment; ID = Identification
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