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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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COUNTRY CLUB
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1403
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2300 - Underground Storage Tank Program
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PR0231995
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
1/18/2023 3:31:12 PM
Creation date
3/26/2021 3:44:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231995
PE
2361
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
01
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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00 <br /> Certificate Number:02-019A24 <br /> er m i °m <br /> Page 18 of 19 <br /> A ,� Oyu ANO�� <br /> .SS Gilbarco,Inc. <br /> Retail Motor Fuel Dispenser(RMFD)/Nxx Series <br /> Conclusion: The results of the evaluation and information provided by the manufacturer indicate the device complies with applicable <br /> requirements. <br /> Information Reviewed By: T. Butcher, L. Sebring (NIST) 00-035A1; S. Patoray, L. Bernetich (NCWM) 00-035A2, 02-019, 02- <br /> 019A1, 02-019A2, 02-019A3, 02-019A4, 02-019A5, 02-019A6, 02-019A7, 02-019A8, 02-019A9, 02-419A11, 02-019Al2, 02- <br /> 019A 13; J. Truex(NCWM)02-019A 14,02-019A 15,02-019A 16, 02-019A 17, 02-019A 18, 02-019A 19, 02-019A20,02-019A21,02- <br /> 019A22,02-019A23,02-019A24 <br /> Examples of Device: <br /> r <br /> - ca <br /> f ter.; <br /> Nxx Series Tool Box Type Latch Nxx Series Side View Gilbarco Meters Encore with T19976-G5 Flex Fuel Meter <br /> (may be provided with owner supplied lock) <br /> 1 ' <br /> Sealable E cal Switch <br /> Ya;a1.le Eiai.�laA � - <br /> i a ey Pad <br /> \'azl.ui➢h.ay.rnr10:2 w.�..a...n <br /> n plwro <br /> Main Door Open <br /> ault Will Have Enclosed Top <br /> (not shown in photo) <br />
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