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COMPLIANCE INFO_2019
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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PR0231098
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COMPLIANCE INFO_2019
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Entry Properties
Last modified
9/22/2021 9:48:28 AM
Creation date
7/31/2020 11:56:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0231098
PE
2361
FACILITY_ID
FA0003830
FACILITY_NAME
VILLAGE WEST MARINA
STREET_NUMBER
6649
STREET_NAME
EMBARCADERO
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
09815006
CURRENT_STATUS
01
SITE_LOCATION
6649 EMBARCADERO DR
P_LOCATION
01
P_DISTRICT
002
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 3 of s) <br /> FVenVTransiflon <br /> Device Used Device Model Al Monitoring Device Used Device Model # <br /> Sum ID: Transition / Valve Isolation Vent/Transition Sum ID: <br /> ® Sump sensor 794380-205 / 794380-208 ❑ sump Sensor <br /> ❑ VPH Sensor ❑ VPH Sensor <br /> UDC iD: 'I UDC ID: 2 <br /> ® Electronic sensor 794380-208 ® Electronic sensor 794380-208 <br /> ❑ Mechanical Device ❑ Mechanical Device <br /> ❑ VPH Sensor ❑ VPH Sensor <br /> UDC ID: 3 UDC ID: <br /> ® Electronic Sensor 794380=208 ❑ Electronic Sensor <br /> ❑ Mechanical Device ❑ Mechanical Device <br /> ❑ VPH Sensor ❑ VPH Sensor <br /> UDC ID: UDC ID: <br /> ❑ Electronic Sensor ❑ Electronic Sensor <br /> ❑ Mechanical Device ❑ Mechanical Device <br /> ❑ VPH Sensor ❑ VPH Sensor <br /> UDC ID: UDC ID: <br /> ❑ Electronic Sensor ❑ Electronic Sensor <br /> ❑ Mechanical Device ❑ Mechanical Device <br /> ❑ VPH Sensor ❑ VPH Sensor <br /> Other Monitored Component ID: Other Monitored Component ID: <br /> ❑ Other (Specify in section VU.) J ❑ Other (Specify in section Vll.) <br /> Other Monitored Component ID: Other Monitored Component ID: <br /> ❑ Other (Specify In section VtL) ❑ Other (Specify In section Vll.) <br /> Other Monitored Component ID: Other Monitored Component ID: <br /> ❑ Other (Specify in section Vil.) ❑ Other (Specify In section <br /> Include Information for every underground storage tank component monitored by this monitoring system control panel. If the monitoring <br /> system control panel monitors more components than this form accommodates, additional copies of these pages maybe attached. <br /> VII. COMMENTS <br /> Use this section to provide any additional comments about the Inventory of the equipment certified. <br /> i <br /> inIrimifiminn VPH =VarauwrJPniQwimnolvdrnman!irt IIW*IindparilcmncarmuftimttaM <br />
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