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COMPLIANCE INFO_2002 - 2010
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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6131
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2300 - Underground Storage Tank Program
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PR0231223
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COMPLIANCE INFO_2002 - 2010
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Entry Properties
Last modified
12/16/2019 3:26:44 PM
Creation date
12/16/2019 1:48:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2002 - 2010
RECORD_ID
PR0231223
PE
2361
FACILITY_ID
FA0002324
FACILITY_NAME
Pacific Service Station
STREET_NUMBER
6131
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09746418
CURRENT_STATUS
01
SITE_LOCATION
6131 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
KBlackwell
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EHD - Public
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A.J,:RIGHT <br /> p� <br /> THF PACE:'1F TH!S DOCL:IIFNT HAS A Al L!I_TI COLGRF.f)BA""AROUND THAT CHANGES COLOR GRADUALLY!'NO EVENLY FRO' ARK TO LIGHT WITH DARKER APF BOTH LEST <br /> IF <br /> California UST System Operator <br /> INTERNATIONAL <br /> CODE COUNCIL <br /> Candidate ID.- XX4341010651 <br /> Name: KATHY KOTULAK Date: 8/6/2010 <br /> Address: 236 LYNDHURST PL Birth Date: 8/10/1955 <br /> SAN RAMON CA 94583 <br /> EXAMINATION RESULT: PASS <br /> Congratulations! You have passed the above named examination. Your wallet card will be forwarded to <br /> you by ICC within six weeks from the last day of the month in which you tested. This certificate is current <br /> for two years. <br /> You may request a wall certificate from ICC as well. Throughout 2010, this certificate will be provided at <br /> no cost to you, if you request it within 90 days of your exam. Only one wall certificate per exam passed <br /> will be provided to you at no charge. For more information on requesting a wall certificate, go to <br /> www.iccsafe.org/inspector. <br /> It is extremely important that you notify Pearson VUE and ICC of any changes in name and/or address to <br /> avoid the possibility of your wallet card and/or certificate not being received. Please contact Pearson <br /> VUE at 800-275-8301 and ICC at certexamCcDiccsafe.org with changes to your name and address (name <br /> changes may require additional documentation). There may be an additional fee if a certification is <br /> re-issued due to a misspelled name or incorrect address. <br /> ti <br /> com MKIL <br /> KATHY KOTLILAK <br /> CALIFORNIA LIST SYSTEM OPERATOR <br /> The individual named hereon is CERTIFIED in the category shown, <br /> having been so certified pursuant to successful completion of the <br /> prescribed written examinap.ons. <br /> A -11 <br /> d <br /> Expiration date: Augu t ,2012 <br /> No. 5240722 <br /> Ali <br /> Nzrvalid 4less signed by�Artificate holder. <br /> ICC certification attegfs'to&DraKlent knowledge of codes and standards <br /> Ip <br /> II <br /> M 0,1 1 3A 0139917 10 V1083 801(j',)39NiVH3 1-IlM1N3W111007 OUN7Hinv'839N13HI1M0901 ini,rio,.uv i ilHi enH(INV 89AO Nuni isrivy noA IN3wn000 SIH I 30AIIOIIN31411Cj <br />
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