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INSTALL_2013
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0518288
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INSTALL_2013
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Last modified
5/31/2022 3:09:55 PM
Creation date
11/8/2018 10:21:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2013
RECORD_ID
PR0518288
PE
2361
FACILITY_ID
FA0013810
FACILITY_NAME
COSTCO WHOLESALE #658
STREET_NUMBER
3250
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
3250 W GRANT LINE RD
P_LOCATION
03
QC Status
Approved
Scanner
WNg
Supplemental fields
FilePath
\MIGRATIONS3\G\GRANT LINE\3250\PR0518288\INSTALL 2013.PDF
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EHD - Public
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Ultrazol <br /> Manufacturer's Affirmative Statement of Compatibility <br /> (As required by California Code of Regulations section 2631(k)) <br /> Component Current Unique Supporting <br /> Manufacturer(s) Type UL Years of Identifiers for Blend Test Data & <br /> (including prior Model yp Sizes <br /> marketed names) (i.e. pipe, Standard Manufacture Field Evaluation Concentration Documents <br /> tank, etc.) Listing (i.e. color, material) Attached <br /> Containment Additive-DWT6 tank UL file# 2011 -present 550- UL unique number 0-100% and all NO <br /> Solutions, Inc. Double-Wall MH7991 50,000 label, Additive- blends between <br /> fiberglass tank for gallons DWT6 label <br /> Ultrazol storage <br /> For tanks and piping please list only double was products (Insert a company logo below if available) <br /> CONTAINMENT <br /> Manufacturer: Containment Solutions, Inc. SOLUTIONS <br /> Corporate: 5150 Jefferson Chemical Rd <br /> Headquarters: Conroe,TX 77301 <br /> Address: <br /> Phone: 877-CSI-TANK <br /> Email: sales@csiproducts.com <br /> I declare, to the best of my knowledge and belief, that this affirmative statement of compatibility and the information contained herein is t( <br /> correct, and complete. <br /> David Heiman Director of Marketing <br /> Print Name Title <br /> Ma aaurer's Authorized Signature Date <br /> .• Please complete and submit form to Cory Hootman of the SWRC13 at chootman(a�waterboards�ca.gov. 4/2012 <br />
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