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COMPLIANCE INFO_2020
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231309
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COMPLIANCE INFO_2020
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Last modified
11/30/2020 4:29:03 PM
Creation date
10/8/2020 7:37:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231309
PE
2361
FACILITY_ID
FA0003756
FACILITY_NAME
KISHIDA, GEORGE INC
STREET_NUMBER
1725
STREET_NAME
ACKERMAN
STREET_TYPE
DR
City
LODI
Zip
95240
APN
06219001
CURRENT_STATUS
01
SITE_LOCATION
1725 ACKERMAN DR
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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1. 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 /> OeTsEquipment Used: VACUUM GAUGE Equipment Resolution: 0.5" <br /> Tank#DSL1/DSL2 Tank# Tank# Tank# <br /> nk 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: DSL <br /> Wait time between applying <br /> pressure/vacuum/water and 5 MIN <br /> starting test: <br /> Test Start Time: 10:20 <br /> Initial Reading(Ri): -10" 99 99 " <br /> Test End Time: 11:20 <br /> Final Reading(RF): -10" 99 99 <br /> " <br /> Test Duration: 1 HR 1 HR 1 HR 1 HR <br /> Change in Reading(RF-R,): 0 <br /> Pass/Fail Threshold or Criteria: 0 0 0 0 <br /> Test Result: ®Pass ❑ Fail ❑ Pass ❑ Fail ❑Pass ❑ Fail ❑Pass ❑ Fail <br /> Was sensor removed for testing? ❑Yes®No❑NA ❑Yes❑No❑NA ❑Yes❑No❑NA ❑Yes❑No❑NA <br /> Was sensor properly replaced and <br /> verified functional after testin ? El Yes❑No®NA El Yes[—]No El NA El Yes E]No El NA El Yes E]No E]NA <br /> Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> Secondary Containment Test Results 1 of 4 <br />
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