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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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E
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88 (STATE ROUTE 88)
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14971
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2300 - Underground Storage Tank Program
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PR0231911
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COMPLIANCE INFO_2019
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Last modified
11/20/2024 9:21:33 AM
Creation date
9/15/2020 2:19:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0231911
PE
2361
FACILITY_ID
FA0000540
FACILITY_NAME
COUNTRYSIDE LIQUORS & GAS
STREET_NUMBER
14971
Direction
N
STREET_NAME
STATE ROUTE 88
City
LODI
Zip
95240
APN
06316025
CURRENT_STATUS
01
SITE_LOCATION
14971 N HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Program Element:2308 - UST RETROFITTelephone:(209) 461-6337Requestor:MEGAN MITCHELL, ELITE IV CONTRACTORSInspection Type:298 - UST RETROFIT REPAIR INSPECTIONAddress:14971 N HWY 88 , LODI 95240Date:10/31/2019Name of Facility:COUNTRYSIDE LIQUORS & GASUnderground Storage Tank Program Service Request Inspection ReportTime Out:Time In:Request #:SR0081169Environmental Health DepartmentOnsite Service Technician:Michael KennardICC Service Tech/Installer Exp. Date:06/19/2021Manufacturer training:Bravo, 04/02/22OVERALL INSPECTION NOTES AND COMMENTSNOTESOn site for the following inspections:- Verified dispenser footprints contained by the under dispenser containment sumps(UDC) (1/2 and 3/4)- Verified piping within the dispensers (1/2 ans 3/4)All passed visual inspection.The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health andSafety Code. If a reinspection is required, fees will be assessed at the current hourly rate.Received by:Name and Title:EH Specialist:Phone:(209) 468-3432Michael Kennard, Service TechPAUL NSOPage 1 of 1EHD 23-01 Rev. 06/30/15Underground Storage Tank Program Service Request Inspection ReportFA0000540 SR0081169 SC298 10/31/2019
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