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COMPLIANCE INFO_2018
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2300 - Underground Storage Tank Program
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PR0232355
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COMPLIANCE INFO_2018
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Last modified
7/6/2021 9:58:11 AM
Creation date
6/23/2020 6:55:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2018
RECORD_ID
PR0232355
PE
2361
FACILITY_ID
FA0000591
FACILITY_NAME
QUIK STOP MARKET #152
STREET_NUMBER
1721
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
062-060-48
CURRENT_STATUS
01
SITE_LOCATION
1721 S CHEROKEE LN # 1
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232355_1721 S CHEROKEE_2018.tif
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EHD - Public
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..i JOAQUIN En Onmen <br />------COUNTY— J U L j` 0 Z101"' <br />UST SYSTEM RETROFIT OR REPAIR <br />FSEA0i H U } `�,..�-�,.I NT <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES W NO [ j <br />2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training <br />certificates for each person installing or testing any component that is repaired or replaced. Ensure a copy of <br />the "Site Health and Safety 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 <br />diagram drawn to scale showing location of repairs and/or replacements. If repairing a component, describe <br />how this will be done. (If adding piping, UDC's, or other UST equipment, or performing tank top upgrade, <br />use the UST Installation Application pages 4-8 as necessary for a timely plan review): <br />Replaced sensor in 87 STP with like for like equipment. <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />VR 208 Sumn Sensor <br />Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? YES [ ] NO [I <br />b. Identify contractor performing decontamination: <br />Name <br />Address <br />3 of 6 <br />Phone ( ) <br />City Zip <br />
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