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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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1900 - Hazardous Materials Program
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PR0520593
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COMPLIANCE INFO_2021
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Last modified
8/24/2021 8:35:49 AM
Creation date
7/21/2021 10:30:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0520593
PE
1920
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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Monitoring System Certification <br />VST Monitoring Site Plan <br />Site Address: ( 2 _ 1 '� c <br />2........... ...... <br />.G,. ........ ... ........... .. <br />. . . . . . . . . . . . . . . . <br />. . . . . . . . . . .� , <br />. . . . . . . . . . . . <br />. . . . . . . . . . . . . . : . . . . , . . . <br />......... <br />}i <br />a. .', ' . . . . . . . . . . .. . . . . . <br />�...`�............ .......... <br />. . . . . . . . . . . . . . . . .1�3.. <br />Date niap was drawn: ` <br />Instructions <br />If you already have a diagram that shows all required information, you may include it, rather than this page, with your <br />Monitoring System Certification. On your site plan, Ishow the general layout of tanks and piping. Clearly identify <br />locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular <br />spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak <br />detectors; and in -tank liquid level probes (if used for leak detection In the space provided, note the date this Site Plan <br />was prepared. <br />Page I of 1 05100 <br />S <br />
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