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COMPLIANCE INFO_2020
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231692
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
12/22/2020 9:25:12 AM
Creation date
6/11/2020 3:51:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231692
PE
2361
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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UST SYSTEM RETROFIT OR REPAIR <br /> ( Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br /> 1 . Site map enclosed ? YESX 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 jobsite as required by Title 8 . <br /> 3 . Detailed description of work to be completed . List components to be repaired or replaced and attach a diagram drawn <br /> to scale showing location of repairs and/or replacements . If repairing a component , describe how this will be done . ( If <br /> adding piping , UDC ' s , or other UST equipment , or performing tank top upgrade , use the UST Installation Application <br /> pages 4-8 as necessary for a timely plan review) : <br /> Break concrete . Replace 3gal 87 and 91 spill buckets with a 5gal spill buckets . ( � <br /> Replace drop tubes , if necessary . Pour concrete . Test with county upon completion . <br /> 0 fs� (F r\ <br /> SVC Ci s . <br /> WACb <br /> 4 . List of equipment to be used (Attach manufacturer' s specification sheets showing third -party approval ) : <br /> 2 - OPW 5 gallon spill buckets <br /> 2 - OPW fill adaptors <br /> 2 - OPW fill caps <br /> 2 - OPW face seal adaptors <br /> 2 - OPW jack screw kits <br /> 2- OPW 4x7 nipples <br /> EH230038 (revised 12- 11 - 15) 3 <br />
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