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COMPLIANCE INFO_2023
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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PR0518624
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
12/17/2025 2:32:27 PM
Creation date
3/6/2023 3:48:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0518624
PE
2371 - UST FACILITY - 1702 COMPLIANT
FACILITY_ID
FA0024496
FACILITY_NAME
Costco Wholesale #38 ‎(Gas Station)‎
STREET_NUMBER
1630
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
Stockton
Zip
95210
APN
09428011
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
Site Address
1630 E Hammer LN Stockton 95210
Tags
EHD - Public
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ULTRAZOL®GA9058 (OS634188E) <br />Manufacturer's Affirmative Statement of Compatibility <br />(As required by California Code of Regulations section 2631(k)) <br />(As reauired by Federal Reaulation CFR Title 40_ Chanter 1 _ Suhchenter 1 Part 280 39 (h)91 )(ill) <br />Manufacturer(s) <br />(including prior <br />marketed names) <br />Model <br />Component <br />Type <br />(i.e, pipe, <br />tank, etc.) <br />Current <br />UL <br />Standard <br />Listing <br />Years of <br />Manufacture <br />Sizes <br />Unique <br />Identifiers for <br />Field Evaluation <br />(i.e. color, material) <br />Blend <br />Concentration <br />Supporting <br />Test Data & <br />Documents <br />Attached <br />Yes/No <br />Jomar <br />Valve <br />T -SS -1001 N <br />100-964yellow <br />Ball Vavle <br />YES <br />3/4' <br />SS, '/4 turn, <br />handle <br />r <br />cm <br />LO <br />r <br />d <br />rui Lanes anu pipiny piease list ony aoume wail proaucts <br />Manufacturer: <br />Corporate: <br />Headquarters: <br />Ad d ress: <br />Phone: <br />Email: <br />Jomar Valve <br />7243 Miller Dr <br />Warren, MI <br />586-268-1220 <br />csr@jomar.com <br />insert a company logo below a available) <br />e'Omar' <br />I declare, to the best of my knowledge and belief, that this affirmative statement of compatibility and the information contained herein is true, <br />correct, and complete. <br />Rick Rank Engineering Manager <br />Print Nam <br />nufacturer's `Authorized Signature <br />Title <br />Date r <br />r•. <br />z <br />r <br />cm <br />LO <br />r <br />d <br />r <br />1 »MIZ <br />
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