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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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18662
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2300 - Underground Storage Tank Program
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PR0505356
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
11/20/2024 9:21:36 AM
Creation date
2/24/2022 12:42:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0505356
PE
2361
FACILITY_ID
FA0006733
FACILITY_NAME
GEORGES BP MINI MART
STREET_NUMBER
18662
Direction
N
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
CURRENT_STATUS
01
SITE_LOCATION
18662 N HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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<br /> <br /> <br /> <br />CERS = California Environmental Reporting System, GPH = Gallons Per Hour, ID = Identification, <br />ICC = International Code Council, LLD = Line Leak Detector, NA = Not Applicable, SW = Single- <br />Walled, UDC = Under-Dispenser Containment, UST = Underground Storage Tank, <br />VPH = Vacuum/Pressure/Hydrostatic <br />Page 1 of 6 <br />TYPE OF ACTION Installation Repair 12 Month <br />1. FACILITY INFORMATION <br />CERS ID <br /> <br />Certification Date <br /> <br />Facility Name <br /> <br />Facility Address <br /> <br />City <br /> <br />ZIP Code <br /> <br />2. SERVICE TECHNICIAN INFORMATION <br />Company Performing the Certification <br /> <br />Phone <br /> <br />Mailing Address <br /> <br />Service Technician Performing Test <br /> <br />Contractor/Tank Tester License Number <br /> <br />ICC Number <br /> <br />ICC Expiration Date <br /> <br />3. TRAINING AND CERTIFICATIONS <br />Manufacturer and Test Equipment Training Certifications Expiration Date <br /> <br /> <br /> <br /> <br /> <br />4. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br />I hereby certify that the monitoring system is operational in accordance with California Code <br />of Regulations, title 23, division 3, chapter 16, section 2638; that required supporting <br />documentation is attached; and all information contained herein is accurate. <br />Service Technician Signature Date <br /> <br />Total # of Pages <br />
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