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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PICCOLI
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1990
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2800 - Aboveground Petroleum Storage Program
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PR0527887
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
10/10/2019 2:03:48 PM
Creation date
9/14/2018 1:15:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2800 - Aboveground Petroleum Storage Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0527887
PE
2831
FACILITY_ID
FA0003826
FACILITY_NAME
Supervalu
STREET_NUMBER
1990
Direction
N
STREET_NAME
PICCOLI
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10121001
CURRENT_STATUS
01
SITE_LOCATION
1990 N PICCOLI RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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S_-\JoaQt.'m C ot.%TY <br /> E`viROi mE::-AL HF-ALT-r; <br /> 600 Eta Mma 5_eet.StoclaciL Ca 95202-3C29 <br /> Telephone:(209)468-34'0 F2r:s,'2091%468-3433 3 eb:,,,re » •�r�cl, <br /> RETURN TO CO\IPLIANCE CERTIFICATION <br /> Jan--VIII OR violations noted in the"Notice to Comply-in the attached Inspection Report must be <br /> corrected within 30 day..of receipt of this inspection. Thi;certification form must be submitted to the <br /> Eng:iromuental Health Department(EHD)eddies at the top of this form within 35 days of receipt of tl:e <br /> Inspection Report. <br /> All corrections to other-•iolanons noted in the attached Inspection Report(IR)or Continuation Fcrn:. or <br /> disputes to ani *:ic:atians. are to be submitted using this certification:and returned to EHD,.s•ithin-;� day:s <br /> unless otherwise specified in the Inspecti..:i Report. <br /> More: All EHD ;riff rune associated«-ith failing to comply by the abov-r noted dates will be billed at <br /> dir current iioui l-.-rare ,`1.'_1. <br /> Fol, tlils celllticc'1t1011 to be complet.,-lie operator of the site must include: <br /> • A statement documenting-,�hat conecti-:e actions% ere taken or will be taken for each violation <br /> • Copies of sample results manifests.tralnii g records other appropriate paperwork. iiid'or photos <br /> -:errf�'ins corrections <br /> • Operator's certification <br /> Inspection Dare: ' Decen•ber 2010 Inspected Bv: Thuy Tran <br /> Facilin-Address: 1990 Piccol Road. Stockton,Califomia EPA IDg: CAD9a�s0625 <br /> I certifi•under penalty of lain that: <br /> I have corrected the violations specified tri the Inspection Report from the above-mentioned <br /> ii:spection date. <br /> �. I have personally examined the following documentattcn submitted as proof of compliance FOR <br /> EACH VIOLATION and I believe the information-o be-tae.ac cunite.and complete: <br /> Photos Papera•orl:_ ✓ Stateruent <br /> I ani authorized to submit this certification or:behalf of the Respendent. <br /> �. I am a.:are that there are significant penalties for submitting false information.including the <br /> • , sibilir; a fine and,or imprisonment for known violations. (HSC 25191) <br /> Name: Pa-rick.G.i'erinety Title:Director Environriental Health&Safetj <br /> Siffilature: �� Date: <br /> E'=L: 02-005 Rev 0&10 <br />
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