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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
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EHD - Public
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6. UNDER-DISPENSER CONTAINMENT C 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 /> *Testipment Used: INCON TS-STS Equipment Resolution:0.0001 <br /> UDC#9/10 UDC# 11/12 UDC# UDC# <br /> nufacturer: UNK U N K <br /> UDC Material: PLASTIC PLASTIC <br /> UDC De the 28" 28" <br /> Height from UDC Bottom to Top 811 <br /> 8" <br /> of Highest Piping Penetration: <br /> Height from UDC Bottom to 1011 10" <br /> Lowest Electrical Penetration: <br /> Condition of UDC prior to FAIR FAIR <br /> testing: <br /> Portion of UDC Tested' 20" 20" <br /> Does turbine shut down when <br /> UDC sensor detects liquid(both ®Yes❑No❑NA N Yes❑No❑NA ❑Yes❑No❑NA ❑Yes❑No❑NA <br /> product and water)?" <br /> Turbine shutdown response time 6 SEC 6 SEC <br /> Is system programmed for fail- <br /> safe shutdown?' N Yes[:1No[:1NA N Yes ElNo ElNA ElYes 1:1No ElNA ElYes E]No E]NA <br /> Was fail-safe verified to be N Y� No NA ❑Yes❑No❑NA <br /> op erational?' ❑ ❑ ®Yes❑No❑NA ❑Yes❑No❑NA <br /> Wait time between applying <br /> pressure/vacuum/water and 15 MIN 15 MIN <br /> starting test <br /> Test Start Time: 12:24 12:24 <br /> Initial Reading(Ri): 0.8178 3.1544 <br /> Test End Time: 12:39 12:39 <br /> Final Reading(RF): 0.8171 3.1540 <br /> Test Duration: 15 MIN 15 MIN 15 M 1 N 15 MIN <br /> Change in Reading(RF-Ri): 0.0007 0.0004 <br /> Pass/Fail Threshold or Criteria: 0.002 0.002 0.002 0.002 <br /> Test Result: N Pass ❑ Fail N Pass El Fail ❑ Pass <br /> ❑ Fail El Pass El Fail <br /> Was sensor removed for testing? N Yes❑No❑NA N Yes❑No❑NA ❑Yes❑No❑NA ❑ Yes❑No❑NA <br /> Was sensor properly replaced and N Yes No NA ❑ ❑ <br /> verified functional after testing? <br /> ❑ ❑ ®�'�❑No❑NA ❑ Yes❑No❑NA El No NA <br /> Comments— (inchale information on repairs made prior to testing and recommended follow-up for failed tests) <br /> Secondary Containment Test Results 6 of 6 <br />
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