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COMPLIANCE INFO_2020
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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PR0231801
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COMPLIANCE INFO_2020
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Last modified
8/30/2021 10:50:01 AM
Creation date
6/18/2020 9:09:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231801
PE
2361
FACILITY_ID
FA0003290
FACILITY_NAME
COUNTRY MART GAS & FOOD
STREET_NUMBER
34243
Direction
S
STREET_NAME
CHRISMAN
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
25318004
CURRENT_STATUS
01
SITE_LOCATION
34243 S CHRISMAN RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\kblackwell
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EHD - Public
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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page 3 of s) <br /> Monitoring Device Used Device Model# Monitorin g Device Used Device Model# <br /> VENT/TRANSITION SUMP ID: VENT/TRANSITION SUMP ID: <br /> ❑Sump Sensor ❑Sump Sensor <br /> ❑VPH Sensor ❑VPH Sensor <br /> UDC ID: 1 / 2 UDC ID: 3 / 4 <br /> ❑x Electronic Sensor 2 0 8 x❑Electronic Sensor 2 0 8 <br /> ❑Mechanical Device ❑Mechanical Device <br /> ❑VPH Sensor ❑VPH Sensor <br /> UDC ID: rJ / 6 UDC ID: 7 / 8 <br /> ❑x Electronic Sensor 2 0 8 ❑x Electronic Sensor 2 0 8 <br /> ❑Mechanical Device ❑Mechanical Device <br /> ❑VPH Sensor ❑VPH Sensor <br /> UDC ID: g / 10 UDC ID: 11 SATELITE <br /> ❑x Electronic Sensor 2 0 8 ❑x Electronic Sensor 2 0 8 <br /> ❑Mechanical Device ❑Mechanical Device <br /> ❑VPH Sensor ❑VPH Sensor <br /> UDC ID: 11 / 12 SATELITE UDC ID: 12 / 13 _ <br /> Electronic Sensor 2 0 8 x❑Electronic Sensor 2 0 8 <br /> ❑Mechanical Device ❑Mechanical Device <br /> ❑VPH Sensor ❑VPH Sensor <br /> Other Monitored Component ID: 13 SATELITE / 14 Other Monitored Component ID: <br /> ❑x Other(Specify in section Vll.) 2 0 $ j ❑Other(Specify in section VII.) <br /> Other Monitored Component ID: Other Monitored Component ID: <br /> ❑Other(Specify in section Vll.) ❑Other(Specify in section Vll.) <br /> Other Monitored Component ID: Other Monitored Component ID: <br /> ❑Other(Specify in section Vll.) ❑Other(Specify in section Vll.) <br /> Include information for every underground storage tank component monitored by this monitoring system control panel. If the monitoring system <br /> control panel monitors more components than this form accommodates additional copies of these pages may be attached. <br /> VII. COMMENTS <br /> Use this section to provide additional comments about the inventory of the equipment certified. <br /> ID=Identification,VPH=Vacuum/Pressure/Hydrostatic,UDC=Under-Dispenser Containment <br />
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