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COMPLIANCE INFO_2020
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0516248
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
12/15/2020 7:52:05 AM
Creation date
7/16/2020 1:06:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0516248
PE
2361
FACILITY_ID
FA0012532
FACILITY_NAME
CHEVRON STATION #209167
STREET_NUMBER
1234
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
22120016
CURRENT_STATUS
01
SITE_LOCATION
1234 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM ( Page ', 3 of 6) <br /> Monitoring Device Used Device Model # 7VentITransition <br /> onitoring Device Used Device Model # <br /> Vent/Transition Sump ID : Sump ID : <br /> Sump Sensor mp Sensor <br /> 1° VPH Sensor r VPH Sensor <br /> UDC ID : UDC ID : <br /> Electronic Sensor I Electronic Sensor <br /> Mechanical Device I Mechanical Device <br /> r VPH Sensor VPH Sensor <br /> UDC ID : UDC ID: <br /> Electronic Sensor r Electronic Sensor <br /> Mechanical Device ( Mechanical Device <br /> VPH Sensor VPH Sensor <br /> UDC ID : UDC ID : <br /> Electronic Sensor F: Electronic Sensor <br /> r Mechanical Device ( Mechanical Device <br /> VPH Sensor VPH Sensor <br /> UDC 1D : UDC ID : <br /> Electronic Sensor Electronic Sensor <br /> Mechanical Device 17� Mechanical Device <br /> C VPH Sensor VPH Sensor <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> Other(Specify in section VII ) r; Other(Specify in section VII) <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> rOther(Specify in section VII) I'Other(Specify in section VII ) <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> C7:Other(Specify in section VII) r�Other(Specify in section VII) <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 additoinal copies of these pages may be attached. <br /> VII . COMMENTS <br /> Use this section to provide any additional comments about the inventory of the equipment certified. <br /> WAS ONLY HERE TO RE-TEST PROBES AND EXTERNAL ALARM AND MAKE <br /> SURE IT WAS WORKING CORRECTLY. . . <br /> CERS=California Environmental Reporting System , ID=Identification, UST= Underground storage tank, ICC=International Code Council <br />
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