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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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YOSEMITE
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1777
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2300 - Underground Storage Tank Program
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PR0232397
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COMPLIANCE INFO_2020
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Last modified
7/30/2020 4:50:25 PM
Creation date
6/18/2020 4:26:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0232397
PE
2361
FACILITY_ID
FA0003978
FACILITY_NAME
KAISER FOUNDATION - MANTECA
STREET_NUMBER
1777
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
20018034
CURRENT_STATUS
01
SITE_LOCATION
1777 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of 6) <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> A ❑ I B 1 c 1 T D ❑ <br /> A ❑ I B ❑ I C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> Qindustry Code or Engineering Standard (Specify) : <br /> PEI RP 1200 <br /> ❑ Engineered Method (Specify) : <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Tank Containment Testing Training and Certifications (List applicable certifications) Expiration Date <br /> See Attached <br /> VI . COMMENTS <br /> Provide any additional comments here. <br /> VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> A ❑ B ❑ I C ❑ D ❑ <br /> A ❑ B ❑ I C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify): <br /> ❑✓ Industry Code or Engineering Standard (Specify) : <br /> PEI RP 1200 <br /> ❑ Engineered Method (Specify): <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Product Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> See Attached <br /> Interstitial Communication Verification Method Used: <br /> VIII . COMMENTS <br /> Provide any additional comments here. <br /> ID = Identification <br />
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