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COMPLIANCE INFO_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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REYNOLDS RANCH
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2680
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2300 - Underground Storage Tank Program
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PR0535432
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
1/18/2024 2:54:38 PM
Creation date
5/5/2023 2:53:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0535432
PE
2351
FACILITY_ID
FA0020431
FACILITY_NAME
COSTCO WHOLESALE #1091
STREET_NUMBER
2680
STREET_NAME
REYNOLDS RANCH
STREET_TYPE
PKWY
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
2680 REYNOLDS RANCH PKWY
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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ULTRAZOL®GA9058 <br /> Manufacturer's Affirmative Statement of Compatibility <br /> (As required by California Code of Regulations section 2631 (k)) <br /> As require by Federal Re ulation CFR Title 40 , Chapter 1 , Subchapter 1 , Part 280 . 32 b 91 ii <br /> Component Current Unique Supporting <br /> Manufacturer(s) p UL Years of Identifiers for Blend Test Data & <br /> (including prior Model Type Sizes Documents <br /> marketed names) (i . e. pipe, Standard Manufacture Field Evaluation Concentration Attached <br /> tank, etc. ) Listing ( i .e. color, material) Yes/No <br /> STAYFLOW YSTO WYE STR NA 9 '/z" — UNPAINTED 304 100% EACH NO <br /> PRODUCTS 2" SS INGREDIENCE <br /> For tanks and piping please list only double wall products ( Insert a company logo below if available) <br /> Manufacturer: <br /> Corporate : <br /> Headquarters : <br /> Address : <br /> Phone : <br /> Email : <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 /> dim iow�e S� �� s A &soc • <br /> Title <br /> rint N <br /> 2 - IS - Zo <br /> Manufacturer's Authorized Signature Date <br />
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