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COMPLIANCE INFO_1998-2007
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2300 - Underground Storage Tank Program
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PR0231488
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COMPLIANCE INFO_1998-2007
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Last modified
8/12/2021 10:51:17 AM
Creation date
6/23/2020 6:49:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1998-2007
RECORD_ID
PR0231488
PE
2361
FACILITY_ID
FA0003910
FACILITY_NAME
H&M - BW #98
STREET_NUMBER
2501
STREET_NAME
JACKSON
STREET_TYPE
AVE
City
ESCALON
Zip
95320
CURRENT_STATUS
01
SITE_LOCATION
2501 JACKSON AVE
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231488_2501 JACKSON_1998-2007.tif
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EHD - Public
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LIST - Tank Page 2 <br />(Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data <br />element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, <br />the Business Section of the Unified Program Data Dictionary.) <br />Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submiftal,is <br />complete and if any pages are separated, <br />458. PIPING SYSTEM TYPE (UNDERGROUND) - For items 458 and 459,'check the tank's piping system <br />459. PIPING SYSTEM TYPE (ABOVEGROUND) information. CHECK ALL THAT APPLY. <br />460. PIPING CONSTRUCTION (UNDERGROUND) - Check the tank's piping construction information. CHECK ALL <br />THAT APPLY, <br />462. PIPING CONSTRUCTION (ABOVEGROUND) - Check the tank's piping construction information. CHECK ALL <br />THAT APPLY. <br />464. PIPING MATERIAL AND CORROSION PROTECTION (UNDERGROUND) - For items 464 and 465, check the <br />465. PIPING MATERIAL AND CORROSION PROTECTION (ABOVEGROUND) tank's piping material and corrosion <br />protection. <br />466. PIPING LEAK DETECTION (UNDERGROUND) - For items 466 and 467, check the leak detection system(s) used <br />467, PIPING LEAK DETECTION (ABOVEGROUND) to comply with the monitoring requirements for the piping. <br />468. DATE DISPENSER CONTAINMENT INSTALLED - If applicable, enter the date that dispenser containment was <br />installed. <br />469. DISPENSER CONTAINMENT TYPE - Check the type of dispenser containment monitoring system. <br />SIGNATURE OF OWNER/OPERATOR - The owner or agent of the owner shall sign in the space provided, This <br />signature certifies that the signer believes that all the information submitted is true and accurate. <br />470. DATE CERTIFIED - Enter the date the page was signed, <br />472. OWNER/ OPERATOR TITLE - Enter the title of the person signing the page, <br />473. PERMIT NUMBER - Leave this blank, this number is assigned by the CUPA. <br />474. PERMIT APPROVED BY - Leave this blank, this is the name of the person approving the permit. <br />475, PERMIT EXPIRATION DATE - Leave this blank, this is completed by the CUPA. <br />UPC F (12/99 revised) 13 Fomierly SWRC B Form B <br />
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