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COMPLIANCE INFO_2021
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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PR0543574
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
1/12/2022 4:20:35 PM
Creation date
2/10/2021 4:19:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0543574
PE
2351
FACILITY_ID
FA0024750
FACILITY_NAME
Harney Lane 76
STREET_NUMBER
141
Direction
E
STREET_NAME
HARNEY
STREET_TYPE
LN
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
141 E HARNEY LN
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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141 E Harney Ln, Lodi, CA 95240 <br />08/18/2021 <br />PHOTO 15: <br />DOrep orts si ed by unauthorized personnel <br />NER/OPERATOR DESCRIPTION OF FOLLOW_Up ACTION <br />Number the follow up actions to correspond to appro riate <br />p compliance issues <br />3. <br />6. OWNER / OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br />I have reviewed the results of the designated UST operator inspection report and provided a <br />description of the action(s) taken or to be taken to correct any compliance issues discovered. <br />Name UST Owner / Operator (print) <br />c- <br />ub I <br />UST 6Vvner/2perator Signature Date Signed <br />7. INSPECTION HISTORY <br />each follow-up action of Section 3 from the previous Designated UST <br />Yes <br />No NA <br />[Has <br />rator Inspection Report been completed appropriately?ach <br />documentation verifying in appropriate service to this report. <br />8. RELEASE DETECTION ALARM HISTORY <br />Attach a copy of the alarm history report/log to this report. <br />Yes <br />No NA <br />Is the monitoring system powered on and in proper operating mode? <br />Has each alarm since the previous inspection been responded to appropriately? <br />(Attach documentation verifying appropriate service to this report.) <br />Have all containment sumps, that have had an alarm since the previous <br />T] T7 <br />designated UST operator inspection report, been responded to by a qualified <br />service technician? <br />PRO543574 <br />Program: UST <br />All answers marked "No" must be described by the designated UST operator in Section 3. <br />Page 2 of 4 <br />VICKY VANG-LEE, EHS Page 15 of 18 <br />
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