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INSTALL_2013
EnvironmentalHealth
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PR0535432
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INSTALL_2013
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Entry Properties
Last modified
7/6/2020 4:41:30 PM
Creation date
11/8/2018 9:53:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2013
RECORD_ID
PR0535432
PE
2351
FACILITY_ID
FA0020431
FACILITY_NAME
COSTCO WHOLESALE #1091
STREET_NUMBER
2680
STREET_NAME
REYNOLDS RANCH
STREET_TYPE
PKWY
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
2680 REYNOLDS RANCH PKWY
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\R\REYNOLDS RANCH\2680\PR0535432\INSTALL PLAN 2013.PDF
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EHD - Public
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Ultrazol <br /> Manufacturer's Affirmative Statement of Compatibility <br /> (As required by California Code of Regulations section 2631(k)) <br /> Manufacturer(s) Component Current Unique Supporting <br /> (including prior Model Type UL Years of Sizes Identifiers for Blend Test Data & <br /> marketed names) (i.e. pipe, Standard Manufacture Field Evaluation Concentration Documents <br /> tank, etc.) Listing (i.e. color, material) Attached <br /> Containment Additive-DWT6 tank UL file# 2011 -present 650- UL unique number 0-100% and all No <br /> Solutions, Inc. Double-Wall MH7991 50,000 label, Additive- blends between <br /> fiberglass tank and gallons DWT6 label <br /> sump for Ultrazol <br /> storage <br /> Containment Double-Wall tank tank sump 2012-present 42"die. Additive label 0-100% and all No <br /> Solutions, Inc. sump upgrade upgrade 48"dia. blends between <br /> 54" dia. <br /> For tanks and piping please list only double was products (Insert a company logo below if available) <br /> CONTAINMENT <br /> Manufacturer: Containment Solutions, Inc. SOLUTIONS <br /> Corporate: 5150 Jefferson Chemical Rd <br /> Headquarters: Conroe,TX 77301 <br /> Address: <br /> Phone: 877-CSI-TANK <br /> Email: sales@csiproducts.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 /> David Heiman Director of Marketing <br /> Print Name Title <br /> 11/1/2012 <br /> Manufacturer Date <br /> Please complete and submit form to Cory Hootman of the SWRCB at chootmanowaterboards(&,ca.aov. 4/2012 <br />
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