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INSTALL_2022
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0518288
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INSTALL_2022
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Entry Properties
Last modified
1/18/2023 9:33:30 AM
Creation date
5/31/2022 1:10:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2022
RECORD_ID
PR0518288
PE
2351
FACILITY_ID
FA0013810
FACILITY_NAME
COSTCO WHOLESALE #658
STREET_NUMBER
3250
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
3250 W GRANT LINE RD
P_LOCATION
03
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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aw) LEAK DETECTION <br /> T E C H N O L O G I E S <br /> Exclusive Providers for MDleak®, MCleakv and PHDleak® Technologies <br /> 2765 East Wieding Road • Tucson,AZ 85706 • Phone 855-255-5325 • FAX: 520.990.8965 <br /> Operations@LeakDetect.net • www.LeakDetect.net <br /> Signed Non-Disturbance Post ELD Contractor Statement <br /> Reference: <br /> Site Name Costco Gas#658 <br /> Site Address 3250 W.Grant Line Road <br /> City iTracy California Zip 115377 <br /> Contractor: <br /> California License# 106008098 <br /> Company Name I Jones Covey Group,Inc. <br /> Address 9595 Lucas Ranch Road <br /> City Rancho Cucamonga State Dn Zip 91703 <br /> Per the office of the State Water Resource Control Board, we are required to provide a signed <br /> agreement (below), which states that there is to be no further ground penetrating work, including <br /> beautification requirements, atop or immediately adjacent to, the UST system are needed or will be <br /> performed after Final ELD testing is performed. Therefore, all construction and landscaping above <br /> and adjacent to the UST system must be completed before our arrival to perform the ELD final test. <br /> Leak Detection technologies also requires all ballast to be removed from tanks containing a liquid <br /> filled interstice 72 hours prior to our technician arrival onsite to perform the final ELD test. <br /> Furthermore, no fluid can be added or removed from the tank primary 72-hour before testing. <br /> Containment Solution (CSI) wet interstice tanks must have brine added to the interstice to 4 inches <br /> above the interstitial reservoir or 4 inches above the bottom of the riser pipe attached to the top of the <br /> reservoir. Please complete this effort within 72 hours or greater of our arrival. Do not fill the riser pipe <br /> above the 4-inch level indicated herein. <br /> LDT has completed this form on behalf of the above, once this form is signed, dated, and returned to <br /> our office, we will notify the appropriate department at the State Water Resource on your behalf. Once <br /> this form has been completed and delivered to the state, the final ELD test dates can be confirmed. <br /> Please sign, print name and date below. <br /> Statement: No further ground penetrating work, including beautification requirements, atop <br /> or immediately adjacent to, the UST system are needed or will be performed <br /> after the Final ELD testing is performed at the above-referenced location. <br /> Digitally signed by Joseph Malcolm <br /> . m C=US,E U= olm@joescom, ="Jones CoveyJose h MalcoI Group,Inc",O9Project Superintendent,CN=Joseph MalcolmContractor, Date2022.08.109:43:30-07'00' Date: �08.19.2022 <br /> ate, 08.19.2022 <br /> Signature <br /> Print Name: Joseph Malcolm <br /> Author David Rabb 1 of 1 <br />
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