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COMPLIANCE INFO_1997
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2300 - Underground Storage Tank Program
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PR0231382
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COMPLIANCE INFO_1997
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Last modified
6/9/2020 8:56:06 PM
Creation date
6/3/2020 9:48:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1997
RECORD_ID
PR0231382
PE
2361
FACILITY_ID
FA0004139
FACILITY_NAME
Plaza liquor and Gas
STREET_NUMBER
2420
Direction
W
STREET_NAME
TURNER
STREET_TYPE
RD
City
LODI
Zip
95242
CURRENT_STATUS
01
SITE_LOCATION
2420 W TURNER RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231382_2420 W TURNER_1997.tif
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EHD - Public
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0 9 <br /> INSTRUCTIONS FOR COMPLETING FORM "C': TANK INSTALLATION CERTIFICATION <br /> GENERAL INSTRUCT IONS <br /> 1. Each to system must ',-,-"ie �n compliance v-! the federal and state technical <br /> standards, contained in law and regulations, -1for tank and piping installation. <br /> 2. This certification shall be completed by e.'Nier the IST® owner or representative. <br /> 3. One certification is required for each tare' Yyfrle;rn, This form shall be used to <br /> make the required certfficatk,)n,, <br /> 4Please type or print requeFt'^.i (for printing, please use a <br /> hard point writing 1nstrurr4nn,,, <br /> 5. Submit the completed certifim-ation to the appropriate Local Implementing Agency. <br /> L INSTALLATION: MARK ALL OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br /> INSTALLATION REQUIREMENTS ARE MET. <br /> 11. OATH: THE TANK OWNER OR AGENT SHALL CERTIFY, BY SIGNING THE <br /> CERTIFICATION, THAT THE INFORMATION PROVIDED ISTRUE AND <br /> CORRECT, THE PERSON'S NAME SHOULD BE PRINTED UNDER THE <br /> SIGNATURE. <br />
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