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COMPLIANCE INFO_2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231692
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COMPLIANCE INFO_2019
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Last modified
9/10/2020 3:54:55 PM
Creation date
9/10/2020 3:45:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0231692
PE
2361
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
KBlackwell
Tags
EHD - Public
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I . TANK ANNULAR TESTING <br /> Company Name : B . Z. Service Station Maintenance <br /> Company Address : 1041 Triangle Ct. , West Sacramento, CA 95605 <br /> Credentials : ® CSLB Licensed Contractor ❑ SWRCB Licensed Tank Tester <br /> License Type : ICC License Number: 433159 <br /> Test Equipment Used : VACUUM GAUGE Equipment Resolution : 0.5" <br /> Tank # 87/91 /DSL Tank # Tank # Tank # <br /> Is Tank Exempt From Testing? ' ❑ Yes ® No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No <br /> Tank Capacity : <br /> Tank Material : FBG <br /> Tank Manufacturer: UNK <br /> Product Stored : UNL/DSL <br /> Wait time between applying <br /> pressure/vacuum/water and 5 MIN <br /> starting test : <br /> Test Start Time : 10 : 50 <br /> Initial Reading (R►) : 40" " <br /> Test End Time : 11 : 50 <br /> Final Reading (RF) : 40" " 19 <br /> " <br /> Test Duration : 1 HR 1 HR 1 HR 1 HR <br /> Change in Reading ( RF-Rj) : 0 <br /> Pass/Fail Threshold or Criteria : 0 0 0 0 <br /> Test Result: ® Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass [:1 Fail ❑ Pass ❑ Fail <br /> Was sensor removed for testing? ❑ Yes ® No El NA El Yes El No No NA F] Yes El No El NA F] Yes El No El NA <br /> Was sensor properly replaced and ❑ yes ❑ No ® NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br /> verified functional after testing? <br /> Comments — (include information on repairs made prior to testing, and recornnnended follow- up fa*failed tests) <br /> Secondary Containment Test Results I of 6 <br />
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