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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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Lubrizol <br /> Manufacturer's Affirmative Statement of Compatibility <br /> (As required by California Code of Regulations section 2631(k)) <br /> Component Current <br /> Manufacturer(s) Com p Unique Supporting <br /> (including prior Model Type UL Years of Sizes Identifiers for Blend Test Data & <br /> marketed names) (i.e. pipe, Standard Manufacture Field Evaluation Concentration Documents <br /> tank, etc.) Listing (i.e. color, material) Attached <br /> Franklin Fueling STPAG75R-VL1-10 STP MH6262 5+ years % HP None UltraZol 9888C Yes, Lubrizol <br /> Systems, Inc. Assessment <br /> Franklin Fueling STP-MLD-D MLD MH17450 5+years N/A None UltraZol9888C Yes, Wilcox <br /> Systems, Inc. Evaluation <br /> For tanks and piping please list only double was products (Insert a company logo below if available) <br /> Manufacturer. Franklin Fueling Systems, Inc. <br /> Corporate 3760 Marsh Road, Madison WI 53718 <br /> Headquarters <br /> Address: <br /> Phone: 800-984-6266 <br /> Email: techserve@franklinfueling.com <br /> Manufacturer: Franklin Fueling Systems, Inc. <br /> Corporate 3760 Marsh Road, Madison WI 53718 <br /> Headquarters <br /> Address: <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 /> Bill Nelson VP-FFS Engineering <br /> Print Name Title \ <br /> ll'o�; 5;-;PT (C( Ol�- <br /> ufacturer's Authorized Signature Date <br /> Please complete and submit form to Cory Hootman of the SWRCB at chootman(cDwaterboards(dca gov. 4/2012 <br />
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