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INSTALL 2018
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0541436
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INSTALL 2018
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Entry Properties
Last modified
7/22/2020 1:59:23 PM
Creation date
11/8/2018 9:40:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2018
RECORD_ID
PR0541436
PE
2351
FACILITY_ID
FA0023750
FACILITY_NAME
AGS FUEL INC DBA CIRCLE K CHEVRON
STREET_NUMBER
1490
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95337
CURRENT_STATUS
01
SITE_LOCATION
1490 S MAIN ST
QC Status
Approved
Scanner
KBlackwell
Supplemental fields
FilePath
\MIGRATIONS3\M\MAIN\1490\PR0541436\2018 INSTALL.PDF
QuestysFileName
2018 INSTALL
QuestysRecordDate
5/2/2018 6:57:48 PM
QuestysRecordID
3878462
QuestysRecordType
12
QuestysStateID
1
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EHD - Public
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i <br /> APPENDIX E(Continued from Page 46) <br /> SITE SKETCH(Indicate specifics of tank installation.) ADDITIONAL NOTES <br /> Note any variations and/or deviations from <br /> instructions(and attach written authorizations): <br /> i <br /> i <br /> I <br /> i <br /> i <br /> i <br /> I <br /> i <br /> I <br /> VERIFYING SIGNATURES <br /> CONTRACTOR TANK OWNER/REPRESENTATIVE <br /> I verify that this information is a true record of the installation Iverify that this lnformationisatrue record ofthe instal lationofthe <br /> of the tanks listed here, tanks listed here,and that I have received a copy of the Installation <br /> Manual and this Tank Installation Checklist. <br /> Name: Name: <br /> Telephone: Telephone: <br /> Email: Email: <br /> Address: Address: <br /> Signature: Signature: <br /> Date: Date: <br /> TO INSTALLER:After tank installation,deliver the Installation Manual with the completed Tank Installation Checklist to the tank owner.Retain a copy <br /> of each foryour records. <br /> TO OWNER:After installation,retain the limited warranty,the Installation Manual and completed Tank Installation Checklist forfuture reference and <br /> to facilitate any warranty claim. <br /> ``L XERXES APPENDIX 47 <br />
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