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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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PR0231580
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COMPLIANCE INFO_2023
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Last modified
11/21/2023 10:47:57 AM
Creation date
3/9/2023 4:17:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0231580
PE
2361
FACILITY_ID
FA0003963
FACILITY_NAME
TRACY 76
STREET_NUMBER
2420
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
Tracy
Zip
95377
APN
23802006
CURRENT_STATUS
01
SITE_LOCATION
2420 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\kblackwell
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EHD - Public
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<br />Underground Storage Tank <br />Secondary Containment Testing Report Form <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 />Test Method Developed by ☐ Manufacturer ☐ Industry Standard ☐ Professional Engineer <br />Test Type ☐ Pressure ☐ Vacuum ☐ Hydrostatic <br />Test Equipment Used: <br /> <br />Sump/UDC ID <br />Sump Manufacturer <br />Sump Depth (inches) <br />Sump Bottom to Top of <br />Highest Pipe Penetration <br />(inches) <br /> <br />Test Start Time <br />Initial Reading <br />Test End Time <br />Final Reading <br />Change in Reading <br />Pass/Fail Criteria <br />Tightness Test Results ☐ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail <br /> <br />Sump/UDC ID <br />Sump Manufacturer <br />Sump Depth (inches) <br />Sump Bottom to Top of <br />Highest Pipe Penetration <br />(inches) <br /> <br />Test Start Time <br />Initial Reading <br />Test End Time <br />Final Reading <br />Change in Reading <br />Pass/Fail Criteria <br />Tightness Test Results ☐ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail <br /> <br />Additional copies of this page may be attached. <br /> <br />8. SUMP/UDC TEST (continued)
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