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COMPLIANCE INFO_2021
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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2300 - Underground Storage Tank Program
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PR0231760
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
8/4/2021 2:07:15 PM
Creation date
3/3/2021 8:18:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231760
PE
2351
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710034
CURRENT_STATUS
01
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 10. MONITORING SITE PLAN <br /> Date site plan was prepared: <br /> If a site plan has been prepared that shows all required information, you may include it, rather than this page, <br /> with your Monitoring System Certification Form. The site plan must show the general layout of tanks and <br /> identify locations of the monitoring panel, and all leak detection equipment and monitoring locations. Include <br /> a legend for all symbols depicted. <br /> SHeAddress: RlfPl-WATERLOO FOOD MART-4345E WATERLOO R6 STCCKTON,CA <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . - . . . . . ATG <br /> [[YE <br /> 0-� <br /> r TL <br /> At. P - - . . . . . . . . . . . . . . . - - . <br /> 0 . . . . . . . . . . . . . . . . . . . . - - ' - <br /> FPH <br /> . . .. . . . . . .. . . . . . . . . . . . . .. . . . . . .. . <br /> TL . . ' . . . - . . . . . . . . . . . . . . . . . . . . . . . . ' . <br /> . . . . . . . . . - <br /> k S <br /> KEY . . . . . . . . . . . . . . . . . . . . . . . . . . . .. - - . . . . . . . . .. . . . . . . <br /> .3=AMPUL R X B X-E . . . . . <br /> F=FILLS . . . . . . . . . . . . . . . . . . . . . . <br /> T=YUR$Lti'E . . . . . . . . . . . . . . . . . . . . . . <br /> P=PROBE . . . . . . . . . . . - - - - . . . - - - - - . . . . . . <br /> V=432OR . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> PIFL4G <br /> X=5UXO.SENSOR <br /> L=Leak 7}etecto-r (URCMS) <br /> h4=14ianwzi . . . . . . . . . . . . . . . . . . . . . . . e rat o mm pang <br /> $_$sine 5eosor exit�shop and <br /> I-Smart 5eosar UDC's.h& <br /> S=STP . . . . . vadelmiDund <br /> C=Flom.&Lha�s <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . drzi ats n z:c=r <br /> E=E Stop weeanna: <br /> D"map ivas drawn: 3fgf21 specuiate';lue <br /> _31 WMScaenaw11.rb1e:aARE c01jtingYWiV?cranLTV a <br /> f.Yq(".7.7' T1 oprraarr ayi!-{r-&—sclet f-HfOT7fRf16?vjPr71F1- -L-'Ing _- <br /> 117110.C1�8 <br /> Instru f,ons <br /> IF you already have a diagram that shows ad required information,you may include Lt rather than this page.with your lWoniYonng System Certsficakn. On your Site plan, <br /> show the general layout of tanks and piping. Clearly§denCdy iDcatiaRS of the foflowing equipment,ff instailed:monitoring system control panels;sensors manitorurg tank <br /> annulai spaces,sumps,dispenser pans,spill containers,or other secondary containment arras-mechanical or eiectrnnn line leak detectors;and in-tank liquid levet <br /> probes(ff used for?eak de;ecthn). In the spam_provided,notethe date;his Site Pgn was prepared. <br /> Monitoring System CertiF"- ion Page d oF4 1,21+U7 <br /> Page 6 of 6 <br />
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