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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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BENJAMIN HOLT
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2905
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2300 - Underground Storage Tank Program
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PR0231952
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COMPLIANCE INFO_2022
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Last modified
11/23/2022 11:08:46 AM
Creation date
1/19/2022 8:52:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231952
PE
2351
FACILITY_ID
FA0003712
FACILITY_NAME
CHEVRON STATION #94275*
STREET_NUMBER
2905
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09760004
CURRENT_STATUS
01
SITE_LOCATION
2905 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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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 0 Manufacturer Ll Industry Standard L) Professional Engineer <br /> Test Type Ll Pressure 0 Vacuum 0 Hydrostatic <br /> Tank ID T2 REG. T1 SUP. T3 DSL <br /> Spill Container Manufacturer: oPw oPw OPw <br /> Nonmetallic 0 Nonmetallic 0 Nonmetallic J Nonmetallic <br /> Method of Cathodic Protection ❑ Other Ll Other Ll Other J Other <br /> Is the spill container minimum 0 yes 0 Yes ® Yes J Yes <br /> capacity five gallons excluding ILI No* U Ido* L No* Ll Ido* <br /> riser volurne? <br /> R) Drain R1 Drain R1 Drain Ll Drain <br /> Method to keep spill container El Pump ® Pump 0 Pump El Pump <br /> empty LJ Other LJ Other LJ Other L.1 Other <br /> ZPass 0 Pass ® Pass LlPass <br /> Spill Container Test Results ❑ Fail Fall Ll Fail 11 Fail <br /> Tank la <br /> Spill Container Manufacturer. <br /> D Nonmetallic EJ Nonmetallic L Nonmetallic Ll Nonmetallic <br /> Method of Cathodic Protection ❑ Other Ll Other L Other 0 Other <br /> Is the spill container minimum LJ yes L1 Yes 0 Yes 0 Yes <br /> capacity five gallons excluding Q No* LJ No* L No* L1 No* <br /> riser volume? <br /> 0 Drain ® Drain L3 Drain 0 Drain <br /> Method to keep spill container L Pump LJPump Ll Pump Ll Pump <br /> empty LJ Other LJ Other Ll Other J Other <br /> Q Pass LA Pass Ll Pass Ll Pass <br /> Spill Container Test Results Ll Fail L] Fail L1 Fail 11 Fail <br /> 8. COMMENTS <br /> Describe a 1 answers marked `'Otber,'"Not"or"Fait"and each proposed remedy, <br /> * Marr here if: <br /> Ll Spill containers do not have a minimum Gapacity capacityof five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />
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