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INSTALL_2013
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PR0527629
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INSTALL_2013
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Last modified
7/6/2020 4:41:30 PM
Creation date
11/4/2018 2:26:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2013
RECORD_ID
PR0527629
PE
2351
FACILITY_ID
FA0018721
FACILITY_NAME
Costco Wholesale #1031
STREET_NUMBER
2440
STREET_NAME
DANIELS
STREET_TYPE
ST
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
2440 DANIELS ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\D\DANIELS\2440\PR0527629\INSTALL PLAN 2013.PDF
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EHD - Public
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Lubrizol <br /> Manufacturer's Affirmative Statement of Compatibility <br /> (As required by California Code of Regulations section 2631(k)) <br /> Manufacturer(s) Component Current UL Unique Supporting <br /> (including prior Model Type Standard Years of Sizes Identifiers for Blend Test Data & <br /> marketed names) (i.e. pipe, tank, Listing Manufacture Field Evaluation Concentration Documents <br /> etc.) (i.e. color, material) Attached <br /> Bravo F-Series Entry fitting MH29867 2006-Present olive-grey 1-100 Yes <br /> For: Additive CO <br /> Bravo F-Series Retrofit-S Retrofit No 2010-Present _ olive-grey 1-100 Yes <br /> For: Additive CO entry fitting <br /> Bravo F-Series Retrofit Retrofit No 2009-Present — olive-grey 1-100 Yes <br /> D-BLR-S entry fitting 1) <br /> For: Additive CO <br /> Bravo F-Series Retrofit Retrofit No 2012-Present — olive-grey 1-100 Yes <br /> D-INR-S entry fitting <br /> For: Additive CO <br /> Bravo FR-Series Reducer Test No 2010-Present — olive-grey 1-100 Yes <br /> For: Additive CO reducer <br /> Bravo B-500 Series Cont. sump MH29867 2003-Present — olive-grey 1-100 Yes <br /> For: Additive CO <br /> For tanks and piping please list only double wall products (Insert a company logo below if available) <br /> Manufacturer: S. Bravo Systems, Inc. <br /> Corporate <br /> Headquarters: WWW.sbrayo.com ��` O <br /> JI <br /> Address: ,•) PROBLEM S�O/ j <br /> Phone: 323-888-4133 +\ <br /> Email: comaatibilitv(cDsbravo.com <br /> I declare, to the best of my knowledge and belief, that this affirmative statement of compatibility and the information contained herein is true, <br /> correct, and complete. <br /> Jonathan Smith Director <br /> Print Name Title <br /> g - <br /> ro - 12 <br /> ,-,Manufacturer's Authorized Signat re Date <br /> ❖ Please complete and submit form to Cory Hootman of the SWRCB at chootman(o)waterboards(a).ca.gov. 412012 <br />
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