Laserfiche WebLink
SECONDARY <br />] r; R REPT"IRTe- ; <br />TESTING )i April 30,2004 w8y vs M <br />1. OWNER INFORMATION ENVIRONMENT HEALTH <br />Name Bonfare Markets, Inc. PERMIT/SERVICES <br />Address 25064 Viking Street, Hayward, CA 94545 Phone # 510-732-5700 <br />Contact Milt DeLacy <br />2. FACILITY INFORMATION <br />Name Bonfare Market #35 <br />Address 15 W. Grantline Road, Tracy, CA 93567 Phone # 510-732-5700 <br />Contact Milt DeLacy <br />3. LOCAL AGENCY INFORMATION <br />Name San Joaquin County Environmental Health Notified April 27, 2004 <br />Address 340 Weber Ave., Stockton, CA 95202 Phone # 209-468-9847 <br />contact UST Team Fax # 209-468-3433 <br />Inspector Present No <br />4. TESTING CONTRACTOR INFORMATION <br />Name Walton Engineering, Inc. Lic # 617238 A, B, Haz <br />contact Michael Walton Phone # 916-373-1152 <br />Address P.O. Box 1025, West Sacramento, CA 95691 Fax # 916-373-1172 <br />Test Technician Phillip Klingman <br />5. SUMMARY OF TEST RESULTS <br />Number of Tank Annulars 3 <br />Number of Secondary Lines 3 <br />Number of Piping Sumps <br />Number of Spill Containers <br />Number of UDC's Tested <br />3 <br />Component <br />Pass Fail <br />Component <br />Pass Fail <br />Annular - Tank #1 <br />Gasoline - 87 <br />0 <br />Spill Container #1 <br />Gasoline - 87 <br />Annular - Tank #2 <br />Gasoline - 87 Siphon <br />0 <br />Spill Container #2 <br />Gasoline - 87 Siphon <br />Annular - Tank #3 <br />Gasoline - 91 <br />0 <br />Spill Container #3 <br />Gasoline - 91 <br />Secondary Line #1 <br />Gasoline - 87 <br />0 <br />U D C #1 <br />Disp # 1/2 <br />Secondary Line #2 <br />Gasoline - 87 Siphon <br />0 <br />U D C #2 <br />Disp # 3/4 <br />Secondary Line #3 <br />Gasoline - 91 <br />0 <br />U D C #3 <br />Disp # 5/6 <br />Piping Sump #1 <br />Gasoline - 87 <br />Piping Sump #2 <br />Gasoline - 87 Siphon <br />Piping Sump #3 <br />Gasoline - 91 <br />6. COMMENTS <br />This is a six month post -construction test. <br />Technician Signature Dates <br />© 2003 Walton Engineering, Inc. <br />