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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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PR0231488
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COMPLIANCE INFO_2021
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Last modified
12/28/2021 10:47:59 AM
Creation date
5/4/2021 9:08:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231488
PE
2361
FACILITY_ID
FA0003910
FACILITY_NAME
H&M - BW #98
STREET_NUMBER
2501
STREET_NAME
JACKSON
STREET_TYPE
AVE
City
ESCALON
Zip
95320
CURRENT_STATUS
01
SITE_LOCATION
2501 JACKSON AVE
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Underground Storage Tank <br />Secondary Containment Testing Report Form <br />8. SUMP/UDC TEST <br />Test Method Developed by ❑ Manufacturer ❑ Industry Standard ® Professional Engineer <br />Test Type ❑ Pressure ❑ Vacuum ® Hydrostatic <br />Test Equipment Used: INCON TS1000-15 MIN. <br />Sump/UDC ID <br />87 <br />91 <br />DSL <br />1/2 <br />Sump Manufacturer <br />Unknown <br />Unknown <br />Unknown <br />Unknown <br />Sump depth (inches) <br />N/A <br />N/A <br />N/A <br />N/A <br />Sump Bottom to Top of <br />Highest Pipe Penetration <br />(inches) <br />N/A <br />N/A <br />N/A <br />N/A <br />Test Start Time <br />10:48 <br />11:48 <br />12:21 <br />1:30 <br />Initial Reading <br />2.9755 <br />4.1212 <br />6.9702 <br />4.3163 <br />Test End Time <br />11:03 <br />12:03 <br />12:36 <br />1:45 <br />Final Reading <br />2.9742 <br />4.1208 <br />69706 <br />4.3153 - <br />Change in Reading <br />.0013 <br />.0004 <br />.0004 <br />.0010 <br />Pass/Fail Criteria <br />0.002 <br />0.002 <br />0.002 <br />0.002 <br />Tightness Test Results <br />® Pass ❑ Fail <br />® Pass ❑ Fail <br />® Pass ❑ Fail <br />® Pass ❑ Fail <br />Sump/UDC ID <br />3/4 <br />Sump Manufacturer <br />Unknown <br />Sump depth (inches) <br />N/A <br />Sump Bottom to Top of <br />Highest Pipe Penetration <br />(inches) <br />N/A <br />Test Start Time <br />1:30 <br />Initial Reading <br />4.8895 <br />Test End Time <br />1:45 <br />Final Reading <br />4.8890 <br />Change in Reading <br />.0005 <br />Pass/Fail Criteria <br />0.002 <br />0.002 <br />0.002 <br />0.002 <br />Tightness Test Results <br />® Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Additional cooies of this ,cage may be attached. <br />Page 4 of 6 <br />
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