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COMPLIANCE INFO_2020
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2200 - Hazardous Waste Program
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PR0519033
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COMPLIANCE INFO_2020
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Last modified
2/10/2020 7:49:48 PM
Creation date
2/10/2020 3:31:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0519033
PE
2220
FACILITY_ID
FA0003685
FACILITY_NAME
DBA CIRCLEK, REFUEL PETROLEUM INC.
STREET_NUMBER
419
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21938610
CURRENT_STATUS
01
SITE_LOCATION
419 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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I12/24/2002 12:33 209577 0 BOYETT PETROLEUM PAGE 07 <br /> SAN JOAQUIN COUNTY UNI D PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.WEBER AVENUE <br /> MCKTON, CA 95202 <br /> RTI XCATION OF RETURNLIQ99M.PLIANCE <br /> For Hazardous Waste Generators <br /> In the matter of the Violation cited on :ALC/-Z%-2- <br /> As <br /> ALC/- Z ?As Identified in the Inspection Report dated l! <br /> Conducted by : / e :;&« <br /> Inspector(s)] [EHD <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation <br /> cited above. <br /> 2• I have personally examined any documentation attached to the <br /> certification to establish that the violations have been corrected. <br /> 3. Based on my examination of the attached documentation and inquiry of <br /> the individuals who prepared or obtained it, I believe that the information <br /> is true, accurate, and complete. <br /> 4. I am authorized to file this certification on behalf of the Respondent. <br /> 5• I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for knowing <br /> violations. <br /> Facility Address IY 4M/TCC j c + FPA ID. Number <br /> Name (Print or Type) Title <br /> Signature Date Signed <br /> ci <br />
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