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COMPLIANCE INFO_2019
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231488
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COMPLIANCE INFO_2019
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Entry Properties
Last modified
12/28/2021 5:31:32 PM
Creation date
9/8/2020 11:58:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
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
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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 ? YES NOM <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 /> replace direct bury fill bucket on tank; excavation required <br /> 4 . List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval ) : <br /> I YP W F0 7(p l C� " EVIZ3�V <br /> 2 <br />
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