Laserfiche WebLink
FRONMENTAL HEALTH DEPARTMENT• <br /> SAN JOAQUIN COUNTY <br /> 1868 E.Hazelton Ave. <br /> Stockton,California 95205 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 <br /> UST Consultation Checklist <br /> Facility <br /> Representative: ;17'1 Z- Date: It- 9 - 2-016 <br /> Title: 0�f7[A.�o9L <br /> Facility Address: 8z4f AVLANAN L-CI$ 64 SR#: 00-7'32. 1 <br /> Comp le[d Task Co ments <br /> Underground Storage Tanks-Facility Form Enter into CERS <br /> Underground Storage Tanks-Tank Forms Enter into CERS <br /> ❑ Financial Responsibility/Letter from Chief <br /> Financial Officer. Due eve 12 months U load document into CERS ON <br /> Underground Storage Tank <br /> Monitoring and Response Plans Enter into CERS <br /> Report#5021 Completed <br /> 1�1❑ Designated UST Operator Statement Upload document into CERS <br /> Best Management Practices(BMP's)for Retail <br /> Gasoline Outlets <br /> ❑ Board of Equalization UST Storage Fee <br /> Account Number Enter into CERS , W(� V r) VL <br /> Monitoring Certification(go over last MC) <br /> Due eve 12 months <br /> Spill Buckets <br /> Sensors/Leak Detectors <br /> Line Test Requirements(if needed or not <br /> for pressurized pi in <br /> Sensor/Leak Detector failures can have <br /> emergency replacement with EHD permit <br /> obtained within of replacement <br /> All other work must have EHD permit <br /> prior to work being performed <br /> UST owner is responsible to see that EHD Submit UST Owner/Operator written agreement(if <br /> permits are properly obtained. applicable). Can upload document to CERS <br /> Required to create a CERS account at <br /> cers.calepa.ca.gov Provide Lead User Authorization Form <br /> Secondary Containment Requirements <br /> Go over last date- Due every 36 movtbs"- ` <br /> ❑ California EPA ID number (N1 '�R ca9c({ Enter into CERS �(r(`n QCT Q <br /> ❑ Hazardous waste generator Permit <br /> Hazardous Materials Management Plan Enter into CERS <br /> Free UST and CUPA Classes Handout Provided <br /> Consultation by: <br />