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COMPLIANCE INFO_1998-2006
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2300 - Underground Storage Tank Program
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PR0231141
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COMPLIANCE INFO_1998-2006
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Last modified
2/26/2024 3:02:37 PM
Creation date
6/3/2020 9:45:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1998-2006
RECORD_ID
PR0231141
PE
2361
FACILITY_ID
FA0003954
FACILITY_NAME
SJ CO PUBLIC WORKS CORP YARD*
STREET_NUMBER
1810
Direction
E
STREET_NAME
HAZELTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
15518002
CURRENT_STATUS
01
SITE_LOCATION
1810 E HAZELTON AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231141_1810 E HAZELTON_1998-2006.tif
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EHD - Public
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Owner Statements of Designated Underground Storage Tank (UST) Operator <br /> and Understanding of and Compliance with UST Requirements <br /> Facility Name: San Joaquin County Public Works Corporation Yard Facility ID#: FA 3954 <br /> Facility Address:1810 E.Hazelton Avenue Reason for Submitting this Form(Check One) <br /> Stockton,CA. 95205 0 Change of Designated Operator <br /> Facility Phone#:209-468-3079 M Update Certificate Expiration Date <br /> Desienated UST Overator(s)for this Facility <br /> PRIMARY <br /> Designated Operator's Name:Rick Tirapelle Relation to UST Facility(Check One) <br /> Business Name(Ifdifferentfrom above): 13 Owner 0 Operator 0 Employee <br /> Designated Operator's Phone#:209-4684645 0 Service Technician 0 Third-Party <br /> International Code Council Certification#:5249958-UC Expiration Date: 12/8/2008 <br /> ALTERNATE 1(OpdonaQ <br /> Designated Operator's Name:Daniel J.McCann Relation to UST Facility(Check One) <br /> Business Name(If different from above): 0 Owner N Operator 0 Employee <br /> Designated.Operatoes Phone#:209468-3106 0 Service Technician 0 Third-Party <br /> International Code Council Certification#:5249834-UC Expiration Date: 11/30/2008 <br /> ALTERNATE 2 (Oph <br /> Wnal <br /> Designated Operatoes Name:Joe Bagley Relation to UST Facility(Check One) <br /> Business Name(If different from above):Bagley Enterprises 0 Owner 0 Operator 0 Employee <br /> Designated Operator's Phone#:209-3674800 0 Service Technician 0 Third-Party <br /> International Code Council Certification#:5297791-UC Expiration Date: 11/29/2008 <br /> 1 certify that,for the facility indicated at the top of this page,the individual(s)listed above will <br /> serve as Designated UST Operator(s). The individual(s)will conduct and document monthly <br /> facility inspections and annual facility employee training, in accordance with California Code of <br /> Regulations,title 23, section 2715(c)-(f). <br /> Furthermore,I understand and am in compliance with the requirements(statutes, <br /> regulations,and local ordinances)applicable to underground storage tanks. <br /> NAME OFT OWNER(Please Print): Spay'Toa r Gr n 6 cs AA <br /> ye, <br /> SIGNATURE OFT OWNER: _ g, <br /> /IfC6411A. <br /> DATE:—to)/0/;PC6 OWNER'S PHONE#: 'OV9-f%S-JVF? <br /> J <br /> NOTE: 1)SUBMIT THIS COMPLETED FORM TO THE LOCAL AGENCY(NOT THE STATE WATER <br /> RESOURCES CONTROL,BOARD)By JANUARY 1,2. .THE LOCAL AGENCY LIST IS AVAILABLE <br /> AT: www.waterboards.ca.loy/ust/contacts/cupa agys.html. <br /> 2)NOTIFY THE LOCAL AGENCY OF ANY CHANGES TO THIS INFORMATION WITHIN 30 DAYS <br /> OF THE CHANGE <br /> November 2004 <br />
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