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Date: Facility Name: IMZC�M Address: City: SR#:—a4r .� <br /> Product ID Capacity Manufacturer Model Composition Approved �'Cu�tSheet <br /> P tY LG11313rd Pary <br /> T 1 f/1 TA 5. L Q gal r Yes UL Yes <br /> A 2 1 1 TA /05 b gal It / P^Yes UL Yes <br /> N 3 tJ TA I,o z� 3� I gal 1 i LI 'Yes UL pYes <br /> K <br /> ELD Permit ❑Yes Calif Certified PE/Licensed Architect ❑Yes 6uoancy Calculation ❑Yes <br /> Product Mechanicall Electronic Pipe Length q Length Capatlble C)Yes UL El Yes <br /> L 1 5--7 �LLIP I�feet U — �vtJ Yes oyes UL Yes <br /> L �✓ <br /> D 2 �'L�D feet (/ �/ u� Yes �C]YesUL Yes <br /> 3 DSL, ) feet Yes ZYes UL Yes <br /> 1°Product Z Ir inches Yes ❑Yes <br /> P 1°Venttr inches (/ I l /r y�Yes <br /> El Yes <br /> I <br /> P 10 Vapor Z inches /! II h ;; Yes ❑Yes <br /> 20 Product I inches �/ I r lr S Yes ❑Yes <br /> N <br /> G 20 Ventl inches /! !r 12 Yes ❑Yes <br /> 20 Vapor 7j I' inches /! (r I r B Yes ❑Yes <br /> STP Sump inches rall/D Yes ❑Yes <br /> S Fill Sump Ltainches I/ Yes ❑Yes <br /> U I 11 'Yes El Yes <br /> M UDC _inches I <br /> P Vent/Transition Sump /r gYes ❑Yes <br /> Product Penetrations S \44-flm h I I-LID-30 1p 1-k4o 0 Yes ❑Yes <br /> Spill Bucket Gasoline in sumps gal ( -'Cr` o f]Yes ❑Yes <br /> OVEROSpill Bucket Diesel in sumps 5 gal /I 8 Yes El Yes <br /> OVER <br /> FILL Overfill Prevention Probe lengthV ^ Mechanical/ e'Ye5 [DYes <br /> 042ZMZQ 's <br /> M Tank Interstitial Liquid Sensor _ �� V _ 34 ual float fives ❑Yes <br /> O Tank Interstitial Vacuum Sensor (/ 3 Vacuum B Yes ❑Yes <br /> N <br /> Sump Liquid Sensor // — g res El Yes <br /> T Sump interstitial Sensor // -7q 4 w Propylene Glycol Yes ❑Yes <br /> O <br /> R UDC Liquid Sensor // ves ❑Yes <br /> I UDC Interstitial Sensor /l _ Propylene Glycol $Yes ❑Yes <br /> N 2°Contained Pipes (/ Yes ❑Yes <br /> G <br /> Alarm Monitoring Panel // 7j (� Yes ❑Yes <br /> Site Mitigation-Notify LOP Septic-0 Well-0 Water-City of Ground Water--t <br />