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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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D
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DE VRIES
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2300 - Underground Storage Tank Program
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PR0231547
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COMPLIANCE INFO_2021
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Last modified
12/28/2021 10:51:43 AM
Creation date
5/5/2021 2:29:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231547
PE
2361
FACILITY_ID
FA0003848
FACILITY_NAME
Verizon Business: KINGCA
STREET_NUMBER
13850
Direction
N
STREET_NAME
DE VRIES
STREET_TYPE
RD
City
LODI
Zip
95242
APN
05524018
CURRENT_STATUS
01
SITE_LOCATION
13850 N DE VRIES RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6 . SPILL CONTAINER DETAILS <br /> Test Method Developed by ❑ Manufacturer Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum Q Hydrostatic <br /> Tank ID Tank#313/ <br /> Spill Container Manufacturer : EBW <br /> ZNonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> Method of Cathodic Protection ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum F%/1 Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No * ❑ No* ❑ No * <br /> riser volume ? <br /> ODrain ❑ Drain ❑ Drain ❑ Valve <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other <br /> ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results <br /> Pass ❑ Pass 1:1Pass ❑ Pass <br /> 171 Fail F-1 Fnol ELEal. F1 Fnel <br /> Tank ID <br /> Spill Container Manufacturer : <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No * ❑ No * ❑ No * ❑ No* <br /> riser volume ? <br /> Method to keep spill container ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Onsite ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8 . COMMENTS <br /> Describe all answers marked "Other, " "No, " or "Fail" and each proposed remedy. <br /> * Mark here if: <br /> ✓❑ Spill containers do not have a minimum capacity of five gallons and require replacement . <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />
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