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COMPLIANCE INFO_2023
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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PR0516248
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COMPLIANCE INFO_2023
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Last modified
10/19/2023 4:01:16 PM
Creation date
1/10/2023 9:35:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0516248
PE
2361
FACILITY_ID
FA0012532
FACILITY_NAME
CHEVRON STATION #209167
STREET_NUMBER
1234
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
22120016
CURRENT_STATUS
01
SITE_LOCATION
1234 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\kblackwell
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EHD - Public
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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 8. SUMP/UDC TEST (continued) <br /> Test Method Developed by ❑ Manufacturer R Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum R Hydrostatic <br /> Test Equipment Used: <br /> Sump/UDC ID UDC 9110 UDC 11112 <br /> Sump Manufacturer <br /> Sump Depth (inches) <br /> Sump Bottom to Top of <br /> Highest Pipe Penetration <br /> (inches) <br /> Test Start Time 10:59 10:37 <br /> Initial Reading 4.2031 4.2451 <br /> Test End Time 11:14 10:52 <br /> Final Reading 4.2019 4.2450 <br /> Change in Reading 0.0012 0.0001 <br /> Pass/Fail Criteria 0.002 0.002 <br /> Tightness Test Results R Pass ❑ Fail R Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Sump/UDC ID <br /> Sump Manufacturer <br /> Sump Depth (inches) <br /> Sump Bottom to Top of <br /> Highest Pipe Penetration <br /> (inches) <br /> Test Start Time <br /> Initial Reading <br /> Test End Time <br /> Final Reading <br /> Change in Reading <br /> PasslFail Criteria <br /> Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Additional copies of this page may be attached. <br /> All tests marked "Fail"and any repairs made before or during the tightness test must be described in <br /> the COMMENTS section. <br /> Page 4 of 5 <br />
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