Laserfiche WebLink
• <br />1. <br />OWNER INFORMATION <br />Number of Tanks Tested <br />Number of Piping Sumps Tested <br />Name Quik Stop Markets <br />Number of Piping Runs Tested 3 <br />Number of UDC Boxes Tested 2 <br />Contact Michael Karvelot <br />Phone # <br />(510) 657-8500 <br />Comments <br />Address 4567 Enterprise Street, Fremont, CA 94538 <br />Annular - Tank #1 <br />Gasoline - 87 <br />• <br />O <br />Annular - Tank #2 <br />Gasoline - 89 <br />• <br />O <br />2. <br />FACILITY INFORMATION <br />Annular - Tank #3 <br />Gasoline - 91 <br />• <br />Name Quik Stop #148 <br />Contact Michael Karvelot <br />Phone # <br />(510) 657-8500 <br />Address 205 W Lockford, Lodi, CA 95240 <br />Secondary Pipe #1 <br />Gasoline - 87 <br />® <br />...... <br />,<;::<:::: <br />- <br />3. <br />LOCAL AGENCY INFORMATION <br />® <br />O <br />Name San Joaquin County Environmental Health <br />Notified <br />Feb 27, 2002 <br />• <br />Contact Tank Team <br />Phone # <br />(209) 468-9847 <br />Address 304 E. Weber Ave., Stockton, CA 95202 <br />Fax # <br />(209) 468-3433 <br />Inspector Present <br />Piping Sump #1 <br />Gasoline - 87 <br />............................... <br />• <br />4. <br />TESTING CONTRACTOR INFORMATION <br />• <br />O <br />Name Walton Engineering, Inc. <br />Lic#/Class <br />617238 A, B, Haz <br />O <br />Contact Michael Walton <br />Phone # <br />(916) 373-1152 <br />Address P.O. Box 1025, West Sacramento, CA 95691 <br />Test Technician James Day <br />U D C #1 <br />Disp # 1/2 <br />• <br />O <br />. SUMMARY OF TEST RESULTS <br />Number of Tanks Tested <br />Number of Piping Sumps Tested <br />3 <br />3 <br />Number of Piping Runs Tested 3 <br />Number of UDC Boxes Tested 2 <br />Component <br />Pass Fail <br />Comments <br />Annular - Tank #1 <br />Gasoline - 87 <br />• <br />O <br />Annular - Tank #2 <br />Gasoline - 89 <br />• <br />O <br />Annular - Tank #3 <br />Gasoline - 91 <br />• <br />O <br />Secondary Pipe #1 <br />Gasoline - 87 <br />® <br />O <br />- <br />Secondary Pipe #2 <br />Gasoline - 89 <br />® <br />O <br />Secondary Pipe #3 <br />Gasoline - 91 <br />• <br />O <br />Piping Sump #1 <br />Gasoline - 87 <br />O <br />• <br />Piping Sump #2 <br />Gasoline - 89 <br />• <br />O <br />` <br />Piping Sump #3 <br />Gasoline - 91 <br />O <br />• <br />U D C #1 <br />Disp # 1/2 <br />• <br />O <br />U D C #2 <br />Disp # 3/4 <br />• <br />O <br />© 2002 Walton Engineering, Inc. <br />Technician Signature <br />Date 3-11 <br />