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COMPLIANCE INFO_2012-2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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14971
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2300 - Underground Storage Tank Program
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PR0231911
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COMPLIANCE INFO_2012-2018
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Last modified
11/20/2024 9:21:33 AM
Creation date
6/23/2020 6:53:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2012-2018
RECORD_ID
PR0231911
PE
2361
FACILITY_ID
FA0000540
FACILITY_NAME
COUNTRYSIDE LIQUORS & GAS
STREET_NUMBER
14971
Direction
N
STREET_NAME
STATE ROUTE 88
City
LODI
Zip
95240
APN
06316025
CURRENT_STATUS
01
SITE_LOCATION
14971 N HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231911_14971 N HWY 88_2012-2018.tif
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EHD - Public
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VSA PYST R TRQFIT OR:',kEPABR. <br />(Submit minimom of 3 sets of pians' ca ons as originals will 'be' retained byEHD): <br />1: Site map enclosed,? y E811 NO'( j <br />2 $ubmot copies of_I I_ ty Servi N --ecnniciart d/ortnstal(er'a ceritiieate_and-ail manuf cxurer.tralnbg gertfigat s r qh.__. . <br />_.,_t <br />person installing o testing ahy col it that isrepalred or:replaced: Ensure a copy of the` "Site Health and Safety <br />Plan". is available.on the)"bte'.as.required!by' itle 8.' <br />3. Detailed descriptio? of workito be complete . List components to be repaired pr replaced and, attach a diagram drawn <br />to scale shbwing Idcation Of a! andldr replacements. If repairing a component, describe how this will be. done:(If -. <br />Adding piping, UD 's, or other UST equipnient, or perfarniing tank top Upgrade, use the UST Installation Application <br />pages 4-8 as nece sary for a tlrmely plan re iew): <br />' I <br />' III I I <br />Iit j. <br />I <br />LI <br />PP <br />• { - .. <br />I <br />.n <br />i � I <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing hird-party approval): <br />
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