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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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88 (STATE ROUTE 88)
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13975
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1900 - Hazardous Materials Program
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PR0521231
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
11/20/2024 9:21:40 AM
Creation date
6/9/2018 2:16:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0521231
PE
1921
FACILITY_ID
FA0000055
FACILITY_NAME
TESORO/SHELL 68150*
STREET_NUMBER
13975
Direction
E
STREET_NAME
STATE ROUTE 88
STREET_TYPE
(none)
City
LOCKEFORD
Zip
95237
APN
01908014
CURRENT_STATUS
Active, billable
SITE_LOCATION
13975 E HWY 88
P_LOCATION
99
P_DISTRICT
004
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\HWY 88\13975\PR0521231\COMPLIANCE INFO 2007 - 2016 .PDF
QuestysFileName
COMPLIANCE INFO 2007 - 2016
QuestysRecordDate
10/18/2017 5:47:15 PM
QuestysRecordID
2994402
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sioov.orc/ehd <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection Report must be <br /> corrected within 30 days of receipt of this inspection. This certification form must be submitted to the <br /> Environmental Health Department(EHD)address at the top of this form within 30 days of receipt of the <br /> Inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections to other violations noted in the attached Inspection Report(IR)or Continuation Form, or <br /> disputes to any violations, are to be submitted using this certification and returned to EHD within 30 days <br /> unless otherwise specified in the Inspection Report. HSC 25185(c)(3) <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be <br /> billed at the current hourly rate. <br /> For this certification to be complete the operator of the Site must include: <br /> • A statement documenting what corrective actions were taken or will be taken for each violation <br /> • Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos <br /> verifying corrections <br /> • Operator's certification <br /> Inspection Date: October 12, 2017 Inspected By:Jamie Lima <br /> Facility Address: 13975 E. Hwy 88 Lockeford EPA ID#: CAR000141911 <br /> I certify under penalty of law that: <br /> 1. I have corrected the violations specified in the Inspection Report from the above-mentioned <br /> inspection date. <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR <br /> EACH VIOLATION and I believe the information to be true,accurate, and complete: <br /> Photos Paperwork Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. 1 am aware that there are significant penalties for submitting false information, Including the <br /> possibility of Jai fine and/or imprisonment for known violations. (HSC25191) <br /> Name: 9 (fir-3E\-�/Zr— Title: Spvs2 <br /> Signature: LEY4?= Date: ll $ tnk M— D <br /> NOV 0 8 2017 <br /> EHD 22-02-005 Rev 04119/12 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br />
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