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COMPLIANCE INFO_2018
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0232482
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COMPLIANCE INFO_2018
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Last modified
7/20/2020 2:04:15 PM
Creation date
7/20/2020 1:37:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2018
RECORD_ID
PR0232482
PE
2361
FACILITY_ID
FA0003719
FACILITY_NAME
WEST LANE CHEVRON
STREET_NUMBER
4747
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
10437010
CURRENT_STATUS
01
SITE_LOCATION
4747 WEST LN
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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KBlackwell
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EHD - Public
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San Joaquin Valley HEALTHY AIR LIVING' <br /> + www.heal thy airliving.cam <br /> AIR POLLUTION CONTROL DISTRICT Make one change for clean air! <br /> TP-201.6C or EVR Liquid Removal Test <br /> Liquid Removal Rate Report Form <br /> Permit Number:N-2522 Test Company:AFFORDA-TEST <br /> Site Name:WEST LANE CHEVRON Technician: ZANE NIMMO <br /> Site Address: 4747 N. WEST LANE Certification Number: 0083 Expiration Date: 2020 <br /> city: STOCKTON, CA Zip:95210 District: SJVAPCO 0083 <br /> Date/Time of Test:9/19/2018 VST(if applicable):3000839502 2019 <br /> TEST INFORMATION <br /> Phase II vapor recovery system executive order: ❑ G-70-52(Pre-Phase II EVR balance for AST&UST) Z VR-203/204(VST Phase H EVR balance) <br /> EVR Short VI G T Dispensing VF Wi Wr VW V1—VW—VF <br /> Nozzle Fuel Version ** Rate G <br /> Number Grade Volume of Gas added to hose Gallons Time to G x 60 Gas drained Gas introduced Gas Liquid removal Pass/Fail <br /> Gas drained (150—175 ml) dispensed dispense 7. after after dispensing recovered Wi-Wr rate(mltgal) <br /> from hose(ml) sec. dispensing 150—175 ml) <br /> I ALL 0 Pass <br /> 2 ALL 0 Pass <br /> 3 ALL 0 Pass <br /> 4 ALL 0 Pass <br /> 5 ALL 0 Pass <br /> 6 ALL 0 Pass <br /> 7 ALL 0 Pass <br /> 8 ALL 0 Pass <br /> I declare, under penalty of perjury under the laws of the state of California that based on information and belief formed after reasonable inquiry, the statements and <br /> information provided in this document are true, accurate, and complete. <br /> Signature of Technician: Date: 9119/2018 <br /> **NOTE: For EVR systems—Prior to the Leak Decay Test,if the liquid drained from the hose is<25 ml,record the amount in the EVR short version column,mark the <br /> test as pass,and no further testing is required. <br /> Ver. 1.5—08.20.14 <br />
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