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INSTALL_1999 TANK TOP UPGRADE
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231883
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INSTALL_1999 TANK TOP UPGRADE
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Last modified
9/25/2019 9:18:52 AM
Creation date
11/8/2018 10:24:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
1999 TANK TOP UPGRADE
RECORD_ID
PR0231883
PE
2351
FACILITY_ID
FA0002111
FACILITY_NAME
BEN HOLT SHELL
STREET_NUMBER
3011
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
10018010
CURRENT_STATUS
02
SITE_LOCATION
3011 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\B\BENJAMIN HOLT\3011\PR0231883\TANK TOP UPGRADE 1999.PDF
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EHD - Public
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Appendix E <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> TABLE OF CONTENTS <br /> Page <br /> SECTION I: FACILITY INFORMATION <br /> (to be completed by all regulated businesses and submitted with any other <br /> pages) <br /> (A) Business Activities 2 <br /> (B) Business Owner/Operator Identification <br /> (OES Form 2730) 3 <br /> SECTION It: HAZARDOUS MATERIALS <br /> (A) Hazardous Materials Inventory-Chemical Description 4 <br /> (OES Form 2731) <br /> SECTION 111: TANKS 5 <br /> (A) Underground Storage Tank (UST)-Facility <br /> (formerly SWRCB Form A) <br /> (B) UST-Tank Pages 1 and 2 6 <br /> (formerly SWRCB Form B) <br /> (C) UST Installation-Certificate of Compliance 8 <br /> (formerly SWRCB Form C) <br /> SECTION IV: HAZARDOUS WASTE 9 <br /> (A) Recyclable Materials Report Pages 1 and 2 <br /> (per HSC §25143.10) <br /> (B) Onsite Hazardous Waste Treatment Notification-Facility Page 11 <br /> (formerly DTSC Form 1772) <br /> (C) Onsite Hazardous Waste Treatment Notification-Unit Pages 12 <br /> (formerly DTSC Forms 1772A, B, C, D, and Q <br /> (D) Certification of Financial Assurance for Permit by Rule and 18 <br /> Conditionally Authorized Onsite Treaters <br /> (formerly DTSC Form 1232) <br /> (E) Remote Waste Consolidation Site Annual Notification 19 <br /> (formerly DTSC Form 1196) <br /> (F) Hazardous Waste Tank Closure Certification 20 <br /> (formerly DTSC Form 1249) <br /> UPCF(1199 revised) i <br />
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