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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 OI' FILL TUBE MEASUREMENT <br />Station Number: <br />Station Address: QVtka-vq <br />bbl \0. � <br />uur , � _, <br />Purpose of visit.: .�_1 1\ "`6�m,ksc> <br />FILL TUBE MEASUREMENT <br />(DO NOT ROUND O F V ) <br />Distance <br />Product FromTank Bottom <br />SU A' %j B �) in. <br />RU AV19- B 92 in. _ <br />"A" DIMENSION MUST NOT EXCEED G" <br />District: <br />V1. -e -S <br />I do certify that the above mcasu rcn-ients are correct and that the <br />highest point of cash fill tubc is within G inches from tank <br />bottom. <br />SIG_NATUR_E <br />COMPANY <br />DATE <br />FORAM 13 <br />
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