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COMPLIANCE INFO 2017 - 2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231760
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COMPLIANCE INFO 2017 - 2018
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Last modified
8/21/2019 11:07:05 AM
Creation date
8/21/2019 9:40:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2017 - 2018
RECORD_ID
PR0231760
PE
2351
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215-2305
APN
08710034
CURRENT_STATUS
01
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
KBlackwell
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EHD - Public
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wwrtoo 12d <br />shu-fes 0,9 Oral) - <br />UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES [ I NO [I <br />2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <br />person installing or testing any component that is repaired or replaced. Ensure a copy of the "Site Health and Safety <br />Plan" is available on the jobsite as required by Title 8. <br />3. Detailed description of work to be completed. List components to be repaired or replaced and attach a diagram drawn <br />to scale showing location of repairs and/or replacements. If repairing a component, describe how this will be done. (If <br />adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST Installation Application <br />pages 4-8 as necessary for a timely plan review): <br />Vent Box - Remove existing interior vent line box and electrical boots. Replace with diversified repair boots. <br />87 STP Sump - Found existing sump top hat port plugged, install new test port, test for communication. <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />DPM RZ 6.7 x 3.5D <br />DPM URZ MS 2.6x1.1 <br />Western Fiberglass 3/8" Stainless Steel Test Port <br />FORVD <br />ENVIRONMEN I AL <br />NTMAf Tw nPPA T MENT <br />EH230038 (revised 12-11-15) <br />
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