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COMPLIANCE INFO 2016 - 2018
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0516526
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COMPLIANCE INFO 2016 - 2018
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Entry Properties
Last modified
5/28/2019 2:27:51 PM
Creation date
10/19/2018 10:08:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016 - 2018
RECORD_ID
PR0516526
PE
2361
FACILITY_ID
FA0012659
FACILITY_NAME
LOVE'S COUNTRY STORES OF CALIF #223
STREET_NUMBER
1553
STREET_NAME
COLONY
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
24534024
CURRENT_STATUS
01
SITE_LOCATION
1553 COLONY RD
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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KBlackwell
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EHD - Public
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UST System Affirmative Statement of Compatibility - Page 3 of 4 <br />Manufacturer <br />Model or Part <br />Year <br />Compatibility With the Specific Product <br />Name <br />Number <br />Manufactured <br />Stored Has Been Demonstrated By <br />❑ Third -party approval (e.g., UL listing) for use with <br />Transition Sump <br />this specific fuel. <br />NA <br />NA <br />NA <br />Statement of Compati- <br />ElbiManufacturer's yposted on SWRCB website. <br />❑ Manufacturer's Affirmative Statement of Compati- <br />bility submitted with this form. <br />Third -party approval (e.g., UL listing) for use with <br />Penetration Fitting <br />this specific fudl. <br />Bravo <br />FF Series <br />2014 <br />❑x Manufacturer's Affirmative Statement of Compati- <br />bility posted on SWRCB website. <br />❑ Manufacturer's Affirmative Statement of Compati- <br />bility submitted with this form. <br />- <br />❑x Third -party approval (e.g., UL listing) for use with <br />Penetration Fitting <br />this specific fudl. <br />Environ - OPW acquired Enviorn <br />DEB & FEB <br />2000 <br />El Manufacturer's Affirmative Statement of Compati- <br />bility posted on SWRCB website. <br />x❑ Manufacturer's Affirmative Statement of Compati- <br />bility submitted with this form. <br />- <br />Penetration Fitting <br />— <br />❑ Third -party approval (e.g., UL listing) for use with <br />this specific full. <br />NA <br />NA <br />NA <br />❑ Manufacturei's Affirmative Statement of Compati- <br />bility posted on SWRCB website. <br />❑ Manufacturer's Affirmative Statement of Compati- <br />bility submitted with this form. <br />❑Third -party approval (e.g., UL listing) for use with <br />Penetration Fitting <br />this specific fuel. <br />NA <br />NA <br />NA <br />❑ Manufacturer's Affirmative Statement of Compati- <br />bility posted on SWRCB website. <br />❑ Manufacturers Affirmative Statement of Compati- <br />bility submitted with this form. <br />Other Cont ►onent That May Contact Stored Product <br />s <br />I () y <br />El Third -party approval(e.g.,ULlisting)forusewith <br />this specific fuel. <br />OPW Emergency Shut Off Valve <br />9 Y <br />10 Series <br />Various <br />i� Manufacturer'sAffumativeStatement ofCompati- <br />bility posted on SWRCB website. <br />❑ Manufacturer's Affirmative Statement of Compati- <br />bility submitted with this form. <br />Other Component(s) That May Contact Stored Product <br />0 Third -party approval (e.g., UL listing) for use with <br />this specific fuel. <br />FE Petro Turbine <br />STP -5-166-51 <br />Various <br />❑ Manufacturer'sAffirmativeStatementofCompati- <br />bility posted on SWRCB website. <br />❑ Manufacturers Affirmative Statement of Compati- <br />bility submitted with this form. <br />Other Component(s)khat Slav Contact Stored Product <br />Third -party approval (e.g., UL listing) for use with <br />this specific fuel. <br />NA <br />NA <br />NA <br />❑ Manufacturer's Affirmative Statement ofCompati- <br />bility posted on SWRCB website. <br />❑ Manufacturer's Affirmative Statement of Compati- <br />bility submitted with this form. <br />Attach additional page(s) if necessary.] <br />UN -100 www.unidocs.org 3/4 - 11/16/15 <br />
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