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COMPLIANCE INFO_2015-2019
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231497
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COMPLIANCE INFO_2015-2019
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Entry Properties
Last modified
10/11/2023 2:05:16 PM
Creation date
6/3/2020 9:50:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2019
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_2015-2019.tif
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EHD - Public
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l <br /> Envirmerital wajth Depatt�inehf <br /> RETURN TU COMPLIANCE CERTIFICATION <br /> ;y, $+d4lnt6tate ndeli the'Nolic to kh/inlitre attached Iftpacbun Reporrsnust�m�e>re wiUd+s so�d <br /> repNpt Qt thea fiepgs on. fih botldt 010.TOM tetuet till SiYM qed to Iho EnOommnehml He t+Dep�lmptd.1tom" <br /> i at am boa of this krarii wtthln }tlayso4 tst.lpf+be the Intµ alnn Report NSC 25 W'l.2( i) <br /> ANto onher n4fFd m the a�aahed IMapocbon Repot(IR)or, tH Ca U0cn Form, <br /> ViataHc ®rli yo'�b stlbtrrlltail ueinp{hkk cern Pion am rvtumeo to EtiD [p Q{yj unlssll alh++wiss R' d itR ttfe <br /> lnspacbm Report HSC 25'185(03} <br /> Note: Ali EHD StOff tlrm associated with failing to eornpty by the above noted'datrs Will,l� <br /> billed at the currant hourly rata, <br /> For this certification.t©be complete, e*operotntolftsftor=rhyiirduds. <br /> A slalament domimenttrnq what correailve edam*we taken or wig bOACr tar each vioakn <br /> C*im of sample resullahaanifestertteining AcordsJo0w em-Peale peGenvom endtor P"Ol s,. <br /> aa�lrlfyrftklns, <br /> O w alooes cothfimlian <br /> tospeetiort Date: Decernber 18,2018. inspected By: Z <br /> Facility Address: 1097 YOSEMITE AVE ESCALON CERS ID: <br /> I bercrsyr under p"ItV of law"L <br /> I I tw/O corrected the vlMsthor ectled to the If' GcWn Heccx$a+ twe shove mbrNJonad in ' <br /> 2 i love 7?!sorhty examined tt>e laliaalno docurr3r et�n submhted et prnnl of aom 1 <br /> end i tilt tiVb the lrtxmatvn to bot q,acwm a and wiiplets, -' <br /> r. <br /> PlhnteE, _PaPerw�rk L'_ SS ' <br /> 3 1 am suthwk"d to subrr+t tfa rerGfiroiion on hehal!cs me Respondent. <br /> 4 t Ofn o t~.Stftre rare siynsthcent per'' ss kx sutxr?11+r9 false htlrnntatlon, <br /> and/arirrhPrisohvntrtt f�buh4v�h viola'Jons. IHBC 2U12i} , <br /> Meme: <br /> ___Pate-. lam" <br /> �II <br /> 71 <br /> 1 <br /> i <br /> t <br /> I <br /> } <br /> t i <br />
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