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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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PR0231497
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
1/25/2022 10:43:11 AM
Creation date
11/10/2021 8:23:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231497
PE
2361
FACILITY_ID
FA0000279
FACILITY_NAME
ESCALON MINI MART
STREET_NUMBER
1097
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22510001
CURRENT_STATUS
01
SITE_LOCATION
1097 YOSEMITE AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Underground Storage Tank <br />Spill ContainerTo ting Report. Form <br />6. SPILL CONTAINER DETAILS <br />Test Method Developed by ❑ Manufacturer V Industry Standard ❑ Professional Engineer <br />Test Type ❑ Pressure ❑ Vacuum Hydrostatic <br />Tank ID <br />8 % <br />Iq I <br />Spill Container Manufacturer: <br />PftxL. - 7 rrE' <br />Phs L" ogre <br />Nonmetallic <br />lonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />Method of Cathodic Protection <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill container minimum <br />Yes <br />Yes <br />❑Yes <br />❑Yes <br />capacity five gallons excluding <br />ElNo* <br />El No* <br />❑ No* <br />❑ No* <br />riser volume? <br />Drain <br />Drain <br />❑Drain <br />❑Drain <br />Method to keep spill container <br />El Pump <br />❑ Pump <br />❑ Pump <br />El Pump <br />empty <br />❑ qMer <br />❑ ther <br />❑ Other <br />❑ Other <br />Pass <br />4 Pass <br />❑ Pass <br />❑ Pass <br />Spill Container Test Results <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />Tank ID <br />Spill Container Manufacturer: <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />Method of Cathodic Protection <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill container minimum <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />capacity five gallons excluding <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ Noy` <br />riser volume? <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />Method to keep spill container <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />Spill Container Test Results <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />B. 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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