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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231345
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
5/20/2019 1:40:56 PM
Creation date
10/11/2018 2:50:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0231345
PE
2381
FACILITY_ID
FA0003713
FACILITY_NAME
CHEVRON #95775 MCCOMBS* (INACT)
STREET_NUMBER
301
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04514002
CURRENT_STATUS
02
SITE_LOCATION
301 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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KBlackwell
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EHD - Public
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CERTIFICATION OF FILL TUBE MEASUREMENT <br />Station Number: <br />-/417 2s - <br />Station Address: 301 1.4. <br />" . gs4ya <br />Purpose of visit: Zw/k <br />NOTE: Measure drop tubes as installed. <br />FILL TUBE MEASUREMENT <br />(DO NOT ROUND OFF) <br />Product <br />Distance <br />From Tank Bottom <br />SU A S� B 3 in - <br />U A (, B 3 in.I < <br />A/, S- B in. A s <br />DIE ylW A B in. <br />"A" DIMENSION MUST NOT EXCEED 6" <br />I do certify that the above measurements are correct and that the <br />highest point of each fill tube is within 6 inches from the tank <br />bottom. <br />]GNATUR <br />Cit <br />COMPANY _��Cfnblc ! r <br />DATE -7-- % j - y 5� <br />
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