Laserfiche WebLink
1= <br /> JNIFIED PROGRAM CONSOLIDATED Fl.. �i. <br /> I' SAN JOAQUIN COUNTY UNIFIED PROGRAM -TANKS <br /> O STORAGE TANKS - INSTALLAT AU <br /> UNDERGROUND S �1V/ G ps <br /> CERTIFICATE OF COMPLIANCE `'V ROnr' 1999 <br /> Pc � <br /> r*e $ e per rank) <br /> a _ <br /> IL FACILITY IDENTIFICATION: <br /> aUSINESS NAME(Same as FACIUTY NAME or GOA-D"au>at+sas As) <br /> anc <br /> AOORESS(For Ocai use o,.W <br /> FAC:UTY 10# ' TANK 10 a 0_(1 0 O U L- <br /> 11.INSTALLATION <br /> (Check all that apply) <br /> The installer has been trained and certified by the tank and piping manufacturers. <br /> The installation has been inspected and certified by a registered professional engineer having education and <br /> experience with underground storage tank installations_ <br /> :9 /The installation has been inspected and approved by the Unified Program Agency. <br /> All work listed on the manufacturer's installation checklist has been completed. <br /> ,;,_�The installer has been certified or licensed by the Contractors' State License Board. <br /> 2--__The underground storage tank, any primary piping,and secondary containment was installed according to i <br /> applicable voluntary consensus standards and written manufacturer's installation procedures. Description of <br /> work being certified: <br /> t I <br /> I <br /> i <br /> i <br /> III.TANK OWNER)AGENTSIGNATURE <br /> I cwnty that the intormabon ofovidod hafewf 4 no and ac=20 to d»beta d my Imowwge. <br /> I <br /> SIGNATURE TANK OWNER/AGENT DATE ! <br /> I <br /> r (?S <br /> 4A(AE OFT#AK OAGJENT OhM TrTLc OF TANK OWNERIAGENT <br /> CUPAFORMS(4/99) FomTerty SVVRCB Form C <br />