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COMPLIANCE INFO 2014 - 2016
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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PR0231760
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COMPLIANCE INFO 2014 - 2016
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Last modified
8/21/2019 10:50:53 AM
Creation date
8/21/2019 9:39:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2014 - 2016
RECORD_ID
PR0231760
PE
2351
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215-2305
APN
08710034
CURRENT_STATUS
01
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
KBlackwell
Tags
EHD - Public
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14 <br />1 ..,1 / <br />I�flt <br />I , <br />f - <br />_ I� <br />I UST SYMM, RETR <br />OFIT_ORREPA�iR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />�: Site map enclosed?_. _ YES [I . No <br />2. Submit copies of. ICC Service Technician and/.or Installer's certificate and all manufacturer training certificates :for each <br />person installing or testing any component that Is repaired or replaced. Ensure a' copy of the "Site 'Health and Safety <br />Plan". is available on the jobsife as. required by Title 8. <br />p p P P - <br />to scpiping,g f work to: ai completed. iacements. If repairing a component, describe how -this a diagram drawn <br />Detailed description oList com onents to be repaired or replaced and attach <br />to scale showiri location of repairs and/or re <br />Q UDC's, or other UST equipment, or performing tank top upgrade, use the UST Installation n A plicatiill be done. on <br />pages 4-8 as necessary for a timely plan review): <br />I <br />i7Kj ) P (`0f¢f-_ <br />/510M a TA/ N> <br />.E� <br />M15 <br />4. List of equipment to be used (Attach manufacturer's specification sheets showina thirri_nnrhi <br />
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