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COMPLIANCE INFO_2021
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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PR0231405
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
1/4/2022 11:10:03 AM
Creation date
3/3/2021 8:27:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231405
PE
2361
FACILITY_ID
FA0003164
FACILITY_NAME
NORTH POLE GAS & FOOD INC
STREET_NUMBER
574
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
574 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 3 of 6) <br /> IX. REMOTE FILL PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from section III for each Manufacturer <br /> A ❑ B ❑ C D ❑ <br /> A ❑ B ❑ C ❑ D ❑ <br /> Test Method Used: <br /> ❑ Manufacturer Guidelines: (Specify) <br /> ❑ Industry Code or Engineering Standard: (Specify) <br /> ❑ Engineered Method: (Specify) <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Remote Fill Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> Interstitial Communication Verification Method Used: <br /> X. COMMENTS <br /> Provide any additional comments here. <br /> XI. VENT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from section III for each Manufacturer <br /> A❑ B ❑ C ❑ D ❑ <br /> A❑ B ❑ C ❑ D ❑ <br /> Test Method Used: <br /> ❑ Manufacturer Guidelines: (Specify) <br /> ❑ Industry Code or Engineering Standard: (Specify) <br /> ❑ Engineered Method: (Specify) <br /> Attach the testing procedures and all documentation required to determine the results. #of Attached Pages <br /> Vent Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> Interstitial Communication Verification Method Used: <br /> XII. COMMENTS <br /> Provide any additional comments here. <br /> I D=Identification <br />
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