COMPLIANCE INFO_2019 - Laserfiche WebLink

Home Browse Search

UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM ( Page 1 of 6) Type of Action ❑ Installation Test ❑ Repair Test ❑ Six Month Test 0 36 Month Test 1 . FACILITY INFORMATION CERS ID Date of Secondary Containment Test 10181461 8/ 16/2019 Business Name (Same as Facility Name or DBA-Doing Business As) Vanco Truck & Auto Report 1 of 2 Business Site Address City ZIP Code 1033 West Charter Way Stockton 1 95206 II . UNDERGROUND STORAGE TANK SERVICE TECHNICIAN INFORMATION Name of UST Service Technician Performing the Test (Print as shown on the /CC Certification) Phone # Benjamin Duncan ( 707 ) 621 - 0378 Contractor / Tank Tester License # ICC Certification # ICC Certification Expiration Date Afford -aAest/90- 1120 5246802- UT 3/20/2021 III . SUMMARY OF SECONDARY CONTAINMENT TESTING RESULTS TANK ID : (By tank number, stored product, etc.) A T- 1 - Race 100 B T-2-91 C T-3 - Regular 87 D T4-Diesel South Tank Containment Tightness Test Result E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA O Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA Product Piping Containment Tightness Test Result E Pass ❑ Fail ❑ NArPassl ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA Communication Test Result E Pass ❑ Fail ❑ NAl ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA Remote Fill Piping Containment Tightness Test Result ❑ Pass ❑ Fail E NAl E NA ❑ Pass ❑ Fail E NA ❑ Pass ❑ Fail E NA Communication Test Result ❑ Pass ❑ Fail E NA ❑ Pass ❑ Fail E NA ❑ Pass ❑ Fail E NA ❑ Pass ❑ Fail E NA Vent Piping Containment Tightness Test Result E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA i Communication Test Result E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA i Vapor Recovery Piping Containment Tightness Test Result E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail E NA I [ Communication Test Result E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA O Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail E NA Turbine 1 Product Piping Sump Tightness Test Result E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA Fill Riser Sump Tightness Test Result E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA f ' VENT I TRANSITION SUMP ID : a b C d Tightness Test Result ❑ Pass ❑ Fail E NA ❑ Pass ❑ Fail E NA ❑ Pass ❑ Fail E NA ❑ Pass ❑ Fail E NA UDC ID : 1 1 &2 2 3&4 3 5&6 4 7-Satelite Tightness Test Result E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA UDC ID : 5 7&8 6 8&9-Satelite 7 9& 10 8 10-Satelite Tightness Test Result E Pass ❑ Fail ❑ NA [HI Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA UDC ID : 9 11 -Satelite 10 11 & 12 11 12& 13-Satelite 12 13& 14 Tightness Test Result E Pass E] Fail E] NA E Pass E] Fail ❑ NA E Pass ❑ Fail ❑ NA E Pass ❑ Fail ❑ NA All items marked "Fail' or "NA " must be explained in their respective "COMMENTS" section. IV. CERTIFICATION BY UST SERVICE TECHNICIAN CONDUCTING THIS TESTING I hereby certify that the secondary containment was tested in accordance with California Code of Regulations , Title 23 , Division 3 , Chapter 16 , Section 2637 and all the information contained herein is accurate. UST Service Technician Signature _� "_.N�"" O i' CERS = California Environmental Reporting System, ID = Identification, UST = Underground Storage Tank, ICC = International Code Coundl, NA = Not Applicable, UDC = Under- Dispenser Containment iI