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COMPLIANCE INFO_1984-1998
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231497
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COMPLIANCE INFO_1984-1998
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Last modified
6/9/2020 4:43:47 PM
Creation date
6/3/2020 9:50:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1984-1998
RECORD_ID
PR0231497
PE
2361
FACILITY_ID
FA0000279
FACILITY_NAME
ESCALON MINI MART
STREET_NUMBER
1097
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22510001
CURRENT_STATUS
01
SITE_LOCATION
1097 YOSEMITE AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231497_1097 YOSEMITE_1984-1998.tif
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EHD - Public
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Ar <br /> INSTRUCTIONS FORCONLETING FORM "C": TANK INSTALLAN CERTIFICATION <br /> GENERAL INSTRUCTIONS <br /> 1. Each tank system must be in compliance with the federal and state technical <br /> standards, contained in law and regulations, for tank and piping installation. <br /> 2. This certification shall be completed by either the UST owner or representative. <br /> 3. One certification is required for each tank system. This form shall be used to <br /> make the required certification. <br /> 4. Please type or print clearly all requested it (for printing, please use a <br /> hard point writing instrument). <br /> 5. Submit the completed certification to the appropriate Local implementing Agency, <br /> INSTALLATION- MARK ALL OF THE ITEMS THAT APPLY TO INDICATE THATTHE <br /> INSTALLATION REQUIREMENTS ARE MET, <br /> OATH: THE TANK OWOR AGENTSHALL CERTIFY, BY SIGNING THE <br /> NE Al <br /> CERTIFICATION, THAT THE INFORMATION PROVIDED IS TRUE AND <br /> CORRECT. THE PERSON'S NAME SHOULD BE PRINTED UNDER THE <br /> SIGNATURE. <br />
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