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COMPLIANCE INFO_2023
Environmental Health - Public
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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3250
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2300 - Underground Storage Tank Program
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PR0518288
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
12/17/2025 2:44:35 PM
Creation date
1/13/2023 9:39:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0518288
PE
2351 - UST FACILITY - 2481 COMPLIANT
FACILITY_ID
FA0013810
FACILITY_NAME
COSTCO WHOLESALE #658
STREET_NUMBER
3250
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95377
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
Site Address
3250 W GRANT LINE RD TRACY 95377
Tags
EHD - Public
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ULTRAZOL®GA9058 <br />Manufacturer's Affirmative Statement of Compatibility <br />(As required by California Code of Regulations section 2631(k)) <br />(As renuired by Federal Renulatinn CFR Title 4n Chanter 1 Riihchnnti-r I Par+ 7Rn io tk1ai /;;\\ <br />— — a anu V V Iiu P Z%30c uaL U1y UlJUU1C VVC11 NIuuUuw <br />Manufacturer: <br />OmegaFlex <br />Corporate: <br />l <br />Headquarters: <br />Unique <br />451 Creamery Way Exton Pa. 19341 <br />Phone: <br />Manufacturer(s) <br />Email: <br />Component <br />Current <br />UL <br />Years <br />Identifiers for <br />C - <br />Supporting <br />Test Data <br />9 prior rior <br />marketed names) <br />Model <br />Type <br />(i.e. pipe, tank, <br />Standard <br />of <br />Manufacture <br />Sizes <br />Field <br />Evaluation <br />Blend <br />Concentration <br />Documents <br />s <br />etc. <br />Listing <br />N <br />C <br />(i.e. color, <br />O <br />w <br />Attached <br />-- <br />material <br />(Yes/No) <br />OmegaFlex <br />DoubleTrac <br />Piping <br />UL971A <br />Since <br />1",1-1/2", 2" <br />SS w/ <br />Up to 10% <br />n/a <br />/UL1369 <br />3/12/2008 <br />Nylon12 <br />OmegaFlex <br />DoubleTrac Flex <br />Piping <br />UL2039 <br />Since <br />3/", 1", 1-1/2", <br />SS braided <br />Up to 10% <br />n/a <br />Connectors <br />7/1/2015 <br />2", 3" <br />— — a anu V V Iiu P Z%30c uaL U1y UlJUU1C VVC11 NIuuUuw <br />Manufacturer: <br />OmegaFlex <br />Corporate: <br />l <br />Headquarters: <br />Address: <br />451 Creamery Way Exton Pa. 19341 <br />Phone: <br />610 524 7772 <br />Email: <br />brian.breitinger@omegaflex.net <br />kmsen: a company logo Delow it available) <br />I declare, to the best of my knowledge and belief, that this affirmative statement of compatibility and the information contained herein is true. <br />correct, and complete. <br />1 <br />Print Name <br />Manufacturers Authorized Signature <br />• � 4 <br />Title <br />Date <br />=. <br />l <br />0- <br />_ <br />_ <br />^' <br />C - <br />C -7 <br />Z <br />l 1 <br />i.. :� <br />C= <br />C <br />N <br />C <br />/_ <br />O <br />w <br />-- <br />1/2023 <br />
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