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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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Entry Properties
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
Tags
EHD - Public
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<br />Underground Storage Tank <br />Spill Container Testing Report Form <br />Additional copies of this page may be attached. <br /> <br />Page 2 of 2 <br />6. SPILL CONTAINER DETAILS <br /> <br />Test Method Developed by ☐ Manufacturer ☐ Industry Standard ☐ Professional Engineer <br />Test Type ☐ Pressure ☐ Vacuum ☐ Hydrostatic <br /> <br />Tank ID <br />Spill Container Manufacturer: <br />Method of Cathodic Protection ☐ Nonmetallic <br />☐ Other <br />☐ Nonmetallic <br />☐ Other <br />☐ Nonmetallic <br />☐ Other <br />☐ Nonmetallic <br />☐ Other <br />Is the spill container minimum <br />capacity five gallons excluding <br />riser volume? <br />☐ Yes <br />☐ No* <br />☐ Yes <br />☐ No* <br />☐ Yes <br />☐ No* <br />☐ Yes <br />☐ No* <br />Method to keep spill container <br />empty <br />☐ Drain <br />☐ Pump <br />☐ Other <br />☐ Drain <br />☐ Pump <br />☐ Other <br />☐ Drain <br />☐ Pump <br />☐ Other <br />☐ Drain <br />☐ Pump <br />☐ Other <br />Spill Container Test Results ☐ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br /> <br />Tank ID <br />Spill Container Manufacturer: <br />Method of Cathodic Protection ☐ Nonmetallic <br />☐ Other <br />☐ Nonmetallic <br />☐ Other <br />☐ Nonmetallic <br />☐ Other <br />☐ Nonmetallic <br />☐ Other <br />Is the spill container minimum <br />capacity five gallons excluding <br />riser volume? <br />☐ Yes <br />☐ No* <br />☐ Yes <br />☐ No* <br />☐ Yes <br />☐ No* <br />☐ Yes <br />☐ No* <br />Method to keep spill container <br />empty <br />☐ Drain <br />☐ Pump <br />☐ Other <br />☐ Drain <br />☐ Pump <br />☐ Other <br />☐ Drain <br />☐ Pump <br />☐ Other <br />☐ Drain <br />☐ Pump <br />☐ Other <br />Spill Container Test Results ☐ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br />1 <br />8. COMMENTS <br />Describe all answers marked “Other,” “No,” or “Fail” and each proposed remedy. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />* Mark here if: <br /> Spill containers do not have a minimum capacity of five gallons and require replacement. <br /> <br />87 OCT <br />OPW <br />91 OCT <br />OPW <br />DSL <br />OPW <br />✔ <br />✔ <br />✔ <br />✔✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔✔
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