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INSTALL 2018
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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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
Tags
EHD - Public
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APPENDIX E(Continued from Page 46) <br /> 011011 <br /> :-zsn�ti il�� r... , r ,.?�:�.� •tr;x. <br /> a k � � ,� � b ESK7C >fjaictpe'di o�l ;�,v w 1Ft�pDITON�IL MOTES "' <br /> Note any variations and/ordeviatilonsfrom <br /> instructions(and attach written authorizations): <br /> i <br /> ; <br /> ,I <br /> , <br /> I <br /> I <br /> I <br /> I <br /> ; <br /> I <br /> I <br /> I <br /> ; <br /> I _ <br /> i <br /> i <br /> i <br /> 1 �V <br /> I n <br /> 1 _ <br /> i CCD <br /> , <br /> i <br /> i <br /> ; <br /> ; <br /> i <br /> ; <br /> � X H a y��c.' :Xraw < ,r x ti �, rr q�• � �t .. �,. .`�.,: <br /> a�i'��-�).�����r r ���m?.a,� z ``y` '�a�a���'e ��vy�r, E, ' .,x, _}� �+,. .•�- �i�t'�k:�� '*�1�� K,-?Y �rte' <br /> CONTRACTOR TANK OWNER/REPRESENTATIVE <br /> I verify that this information is a true record of the installation I verify that this information is a true record of the installation of the <br /> of the tanks listed here. tanks listed here,and that I have received a copy of the Installation <br /> Manual and thisTank Installation Checklist. <br /> Name; �� Name: <br /> Telephone: (2/6) 3 79?.rgg�' Telephone: <br /> Email: Email: <br /> Address: Pp A?1Ve 10Af Address: <br /> — <br /> Signature Signature: <br /> ; <br /> Date: 1 I3 ` 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 for your records. <br /> I <br /> TO OWNER:After installation,retain the limited warranty,the Installation Manual and completed Tank Installation Checklist for future reference and <br /> to facilitate any warranty claim. <br /> ; <br /> ZC1. XERXES APPENDIX E 47 <br />
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