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INSTALL_2020
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0543574
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INSTALL_2020
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Entry Properties
Last modified
11/18/2022 11:26:39 AM
Creation date
7/8/2020 11:49:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2020
RECORD_ID
PR0543574
PE
2351
FACILITY_ID
FA0024750
FACILITY_NAME
Harney Lane 76
STREET_NUMBER
141
Direction
E
STREET_NAME
HARNEY
STREET_TYPE
LN
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
141 E HARNEY LN
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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oLEAK DETECTION <br /> T E C H N n 1.. 0 G 1 L S <br /> Exclusive Providers for MDleak® and PHDleak@ Technologies <br /> 1889 North Oracle Road • "Tucson, AZ 85705 Phone 855-255-5325 • FAX: 520.990.8965 <br /> Sales@LeakDetect.net • www.LeakDetect.net <br /> Signed Non-Disturbance Post ELD Contractor Statement <br /> Reference: R F— C'EIVED <br /> Lodi 76 <br /> 141 E Harney Lane i:?�Y 1 `L 2020 <br /> Lodi <br /> CA 95240 ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br /> Contractor: <br /> License#768938 <br /> Business Name: MVP PETROLEUM ENGINEERING <br /> City: FOLSOM <br /> Per the office of the State Water Resource Control Board, we are required to provide a signed <br /> agreement (below), which states that there is to be no alterations to the site once we have completed <br /> our Final ELD Testing. <br /> Leak Detection technologies also requires all ballast to be removed from tanks containing liquid filled <br /> interstice 72 hours prior to our technician arrival onsite to perform the final ELD test. Furthermore, no <br /> fluid can be added or removed from the tank primary or interstice 72-hour before testing. <br /> The state requires us to have this statement signed and returned to us prior to our arrival on site to <br /> complete the Final ELD Testing. <br /> LDT has completed this form, and once it is signed and returned to our office, we will notify the <br /> appropriate department at the State Water Resource on your behalf. <br /> Please sign and date below. <br /> Thank you! <br /> Statement: No further ground penetrating work, including beautification requirements, atop <br /> or immediately adjacent to, the UST system are needed or will be performed <br /> after the F al ELD testing is performed at the above mentioned location. <br /> Contractor Signature: — Date: <br /> Print Name: Mark Vendeiro <br /> Author Gerardo Paredes 10f 1 <br />
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