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COMPLIANCE INFO_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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2300 - Underground Storage Tank Program
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PR0544259
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COMPLIANCE INFO_2022
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Last modified
8/2/2022 9:43:41 AM
Creation date
1/6/2022 9:07:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0544259
PE
2361
FACILITY_ID
FA0024739
FACILITY_NAME
TOKAY SHELL
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN # 1
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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RECEIVED <br /> Underground Storage Tank JAN 0 7 2022 <br /> Spill Container Testing Report Form <br /> ENVIRONMENTAL <br /> 6 SPILL CONTAINER DETAILS <br /> Test Method Developed by Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum 0 Hydrostatic <br /> Tank ID WASTE OIL <br /> Spill Container Manufacturer: OPW <br /> ❑✓ Nonmetallic ❑ Nonmetallic El Nonmetallic El Nonmetallic <br /> Method of Cathodic Protection ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum p Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No * ❑ No * ❑ No * ❑ No * <br /> riser volume? <br /> p Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container El Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results <br /> 111 Pass El Pass E:1 Pass El Pass <br /> ❑ Fail ❑ Fail ® Fail ❑ Fail <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 p Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No * ElNo* ❑ No* ❑ No * <br /> riser volume ? <br /> Method to keep spill container ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass El 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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