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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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YOSEMITE
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2300 - Underground Storage Tank Program
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PR0515864
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COMPLIANCE INFO_2020
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Last modified
1/19/2021 10:22:56 AM
Creation date
7/16/2020 1:03:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0515864
PE
2361
FACILITY_ID
FA0012355
FACILITY_NAME
A&A GAS FOOD MART
STREET_NUMBER
1330
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
22120053
CURRENT_STATUS
01
SITE_LOCATION
1330 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page s of 6) <br /> Monitorin Device Used Device Model # MonitoringDevice Used Device Model # <br /> VENT I TRANSITION SUMP ID : VENT I TRANSITION SUMP ID : <br /> ❑ Sump Sensor ❑ Sump Sensor <br /> ❑ VPH Sensor ❑ VPH Sensor <br /> UDC ID : 1 / 2 UDC ID : 3 / 4 <br /> p Electronic Sensor 3 2 3 9 Electronic Sensor 3 2 2 <br /> ❑ Mechanical Device ❑ Mechanical Device <br /> El Sensor El VPH Sensor <br /> UDC ID : Jr / 6 UDC ID : 7 / 8 <br /> ❑x Electronic Sensor 3 2 2 9 Electronic Sensor 2 0 8 <br /> ❑ Mechanical Device ❑ Mechanical Device <br /> ❑ VPH Sensor ❑ VPH Sensor <br /> UDC ID : 9 / 10 UDC ID : 11 / 12 <br /> ❑x Electronic Sensor 2 0 8 Z Electronic Sensor 3 2 2 <br /> ❑ Mechanical Device ❑ Mechanical Device <br /> ❑ VPH Sensor ❑ VPH Sensor <br /> UDC ID : UDC ID : <br /> ❑ Electronic Sensor ❑ Electronic Sensor <br /> E:1 Mechanical Device El Mechanical Device <br /> El Sensor E] VPH Sensor <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> ❑ Other (Specify in section VII.) ❑ Other (Specify in section VII.) <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> El Other (Specify in section Vll.) <br /> El Other (Specify in section Vll.) <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> ❑ Other (Specify in section Vll.) <br /> El Other (Specify in section Vll.) <br /> Include information for every underground storage tank component monitored by this monitoring system control panel. If the monitoring system <br /> control panel monitors more components than this form accommodates, additional copies of these Pages may be attached. <br /> VII . COMMENTS <br /> Use this section to provide additional comments about the inventory of the equipment certified. <br /> ID = Identification, VPH = VacuumlPressureMydrostatic, ODC = Under-Dispenser Containment <br />
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