Laserfiche WebLink
AN-VIRONMENTAL HEALTH DEPARTME' <br /> SAN JOAQUIN COUNTY <br /> 1868 E.Hazelton Ave. <br /> Stockton,California 95205 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 <br /> UST Consultation Checklist <br /> Facility 1 <br /> Representative: A Date: <br /> Title: <br /> Facility Address: Z S. L2Y o PR#: <br /> Comp ed Task Comments <br /> Underground Storage Tanks-Facility Form <br /> Underground Storage Tanks-Tank Forms <br /> Financial Responsibility/Letter from Chief � � 111-7 <br /> 1`-7 ha--' <br /> Financial Officer. Due every 12 months <br /> Underground Storage Tank <br /> Monitoring and Response Plans <br /> Report 45021 Completed <br /> Designated UST Operator Statement Prp V-0,0 — P1®-L L'D P/Lic" <br /> Best Management Practices(BMP's)for Retail <br /> Gasoline Outlets <br /> Board of Equalization UST Storage Fee <br /> Account Number �J <br /> Monitoring Certification(go NO Due eve 12 months <br /> Spill Buckets Cvl <br /> Ef Sensors <br /> Leak Detectors <br /> ©/ Line Test Requirements(if needed or not n o-t <br /> for pressurized piping) <br /> Sensor/Leak Detector failures can have <br /> emergency replacement with EHD permit <br /> obtained within 1 of replacement <br /> All other work must have EHD permit <br /> prior to work being performed <br /> UST owner is responsible to see that EHD <br /> permits are properly obtained <br /> Secondary Containment Requirements$ 1as'fiC100 - <br /> Go over last date- Due every 36 months <br /> California EPA ID number <br /> Hazardous waste generator <br /> Hazardous Materials Management Plan <br /> Free UST and CUPA Classes Handout Provided <br /> Consultation by: J J C �f <br />