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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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2300 - Underground Storage Tank Program
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PR0231706
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
11/28/2022 11:20:15 AM
Creation date
2/2/2022 11:14:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231706
PE
2361
FACILITY_ID
FA0000485
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95242
APN
05532024
CURRENT_STATUS
01
SITE_LOCATION
6421 CAPITOL 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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Undet1 M.101I 1 <br /> . s�+a Tani <br /> Qes la ed UST r '1 ual lnspec ionr*port <br /> 1. FACILITY INF( tIATION F <br /> CERS ID 10180605 <br /> inapeon Date <br /> _ 4 <br /> Facility Name Flag City Chevron <br /> Facility Address - <br /> 6421 Capital Ave Cid I ZIP Code <br /> Loi¢f 95242 <br /> 2. DEi� <br /> YID U PFRATOR INF.ORK" <br /> Name:of Designated UST Q eMor <br /> P _. <br /> Alex Jabber/ w7e MR, <br /> t #tone <br /> ICC Certification ... <br /> CelN4n Expiration Date <br /> .... <br /> 01. <br /> 1. <br /> Tank and line tightness test is not required on doublQ yltl: a ,. , <br /> L13: Disp 1-2 alarm on 4/18/21 cleared by itself, Aforda.te `i -the sensor on 4/26/21 no <br /> issue has been.found " <br /> All alarms on 4126121 mere due W aonitoring.oertcp. <br /> ..... . .. <br /> .. - <br /> TED USTy "1R C <br /> 4. CERTIFICATION BY DEQ. y „..:.:: ;:.. <br /> :... <br /> I hereby certify that the visuat Ins pecti on was-Verformed,10mamp1 nm wllKh'C--0ll�rnia Code. <br /> of Regulations,title 2 .� ivisiatt 3,chaptef� ;ae icrrr: ?'t8 end a t.ar ark @rov ided <br /> herein Is aeeurate. <br /> Designated UST Operator Signature //,. t3ate Inp+etiott imports 8d tQ Qwner <br /> CERS =CaliforniaEnvironmental:Reporting System, ICC Jntematlgrral 00i Council,.IQ <br /> Identification, NA = Not Appblea pDC:= Under-Dj4w.seir=Corrtaitlri o t, UST= Unde uf> t <br /> Storage.Tank <br /> bN-111 www.unld0#*j o up t el 1 �� . <br />
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