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COMPLIANCE INFO_2009-2010
Environmental Health - Public
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2300 - Underground Storage Tank Program
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PR0231995
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COMPLIANCE INFO_2009-2010
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Last modified
1/18/2023 11:36:29 AM
Creation date
6/3/2020 9:56:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2009-2010
RECORD_ID
PR0231995
PE
2361
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
01
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231995_1403 W COUNTRY CLUB_2009-2010.tif
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EHD - Public
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CNI Man ufactuAstallation, Operation and Maintenan*Manual (IOM) <br />Applicable to Executive Order VR -1 04-D <br />Phase I EVR Equipment Installation Check List for <br />Installing Products per ARB Executive Order VR -11 04-D <br />Street Address: <br />City/State: <br />Contact/Phone: <br />Installing Technician (name): <br />Tank Number: <br />Tank Number: <br />Tank Number: <br />Business Address: <br />City/State: <br />Contact/Phone: <br />Technician Certification Number: <br />Product Grade: Capacity: <br />Product Grade: Capacity: <br />Product Grade: Capacity: <br />Note: Because this checklist serves a dual purpose as an installation and retrofit checklist, <br />there are some items that will be non -applicable (e.g. cutting riser pipe). The technician should <br />note `N/A' for Non -Applicable in the `Yes/No' box. <br />Yes/No <br />Initials <br />Yes/No <br />Initials <br />Yes/No <br />Initials <br />Yes/No <br />Initials <br />1. Is all of the installed equipment for Phase I EVR listed in ARB <br />Executive Order (E.O.) VR -104-D? <br />Note: All Phase I EVR installed equipment must be listed in <br />E.O. VR -104-D. <br />2. Have all the 4 inch tank risers been cut to the correct lengths and <br />have a flat, square cut across the top of the riser, as well as the <br />appropriate threads cut into the ends of each? <br />3: Are all 4 inch tank risers correctly installed into the tank bungs and <br />the extractors using a Fire Marshall approved thread sealing <br />compound and torqued to 250-350 foot-pounds? <br />4. Fill Riser — Is the CNI DT100 drop tube(s) installed correctly with the <br />CNI DT101 (or RPI 01) O-ring securely in place and the flared end on <br />top of the riser? <br />Note: CNI's drop tube must be cut to the correct length and <br />angle, and assembled before installing into the 4 inch tank riser. <br />Continued on next page. <br />15627 ARROW HIGHWAY, IRWINDALE, CALIFORNIA 91706 <br />PHONE (626) 962-6646; OUT OF STATE CALLS (800) 4CN1-MFG; FAx (626) 962-4854 10 <br />WEBSITE: WWW.CNI-MFG.COM EMAIL: INFO(Q)CNI-MFG.COM <br />
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