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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 SECONDARY PRODUCT PIPE 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 : PRESSURE GAUGE Equipment Resolution : 0. 5 PSI <br /> Piping Run # 87 Piping Run # 91 Piping Run # DSL Piping Run # <br /> Piping Material : FBG FBG FBG <br /> Piping Manufacturer: UNK UNK UNK <br /> Piping Diameter: Y 3 " 3 " <br /> Length of Piping Run : 150 ' 150' 150' <br /> Product Stored : UNL UNL DSL <br /> Method and location of BOOT BOOT BOOT <br /> i in -rim isolation : <br /> Wait time between applying <br /> pressure/vacuum/water and 5 MIN 5 MIN 5 MIN <br /> starting test : <br /> Test Start Time : 10 : 28 11 : 57 1 : 30 <br /> Initial Reading (Rt) : 5 PSI 5 PSI 5 PSI PSI <br /> Test End Time : 11 : 28 12 : 57 2 : 30 <br /> Final Reading ( Rr• ) : 5 PSI 5 PSI 5 PSI PSI <br /> Test Duration: 1 HR I HR 1 HR 1 HR <br /> Change in Reading (RF-Rj) : 0 0 0 <br /> Pass/Fail Threshold or 0 0 0 0 <br /> Criteria : <br /> Test Result: ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ❑ Pass ❑ Fail <br /> Comments — (include information on repairs made prior to testing, and recommended follow- up for failed tests) <br /> Secondary Containment Test Results 2 of 6 <br />
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