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COMPLIANCE INFO_2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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JACKSON
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2501
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2300 - Underground Storage Tank Program
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PR0231488
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COMPLIANCE INFO_2019
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Last modified
12/28/2021 5:31:32 PM
Creation date
9/8/2020 11:58:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0231488
PE
2361
FACILITY_ID
FA0003910
FACILITY_NAME
H&M - BW #98
STREET_NUMBER
2501
STREET_NAME
JACKSON
STREET_TYPE
AVE
City
ESCALON
Zip
95320
CURRENT_STATUS
01
SITE_LOCATION
2501 JACKSON AVE
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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OPV installation record sheet <br /> Date Installed Valve Serial Number <br /> 5 0 O <br /> Site information <br /> Site#/Description <br /> Site Address <br /> Site Contact <br /> Installing Contractor <br /> Name <br /> Company <br /> Tank Information <br /> Product Type <br /> Underground Tank Manufacturer <br /> Tank Full Volume <br /> Tank Diameter <br /> Tank Chart Available? ❑ Yes ❑ No <br /> Tank Type ❑ Steel ❑ Fiberglass <br /> ❑ Square ❑ Cylinder ❑ Dome Ends <br /> Tank have compartments? ❑ Yes ❑ No <br /> Tank/Drop Tube Measurements <br /> Upper Drop Tube Length(X) Dimensions <br /> Lower Drop Tube Length(Y) A <br /> Distance from Lower Drop tube to tank bottom B <br /> Operational Inspection Procedure Performed Final Shutoff Setpoint <br /> Gallons <br /> ❑ Yes Initials Date o <br /> /o Tank Fill <br /> ❑ No <br /> 19 <br /> y 79 Y Jy a <br /> .AS <br /> 3 <br />
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