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COMPLIANCE INFO_2001-2009
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231692
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COMPLIANCE INFO_2001-2009
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Last modified
12/28/2023 11:29:54 AM
Creation date
6/3/2020 9:51:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2001-2009
RECORD_ID
PR0231692
PE
2361
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231692_444 W MOSSDALE_2001-2009.tif
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EHD - Public
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ROBERT BUSH <br />CALIFORNIA LIST SERVICE TECHNICIAN <br />The individual named hereon is CERTIFIED in the category shown, having <br />been so certified pursuant to successful completion of the prescribed <br />written examination. <br />Expiration date: July 11, 20QS <br />No. 5261103 -UT Qklilatiz <br />Not valid unles-9 signed by certificate holder. <br />IC 11"IC cert cation attests <br />10 competent knowledge <br />z <br />1-7 <br />ROBERT BUSH <br />CALIFORNIA UST SYSTEM OPERATOR <br />The Individual named hereon Is CERTIFIED In the category shown, having <br />been so certified pursuant to successful completion of the prescribed writtei <br />examination. <br />Expiration date: June 29, 2009 <br />No. 5261103 -UC <br />_-Ndf valid unless' _y tertif holdi <br />b Icate <br />e <br />ICC certification attests t mpetent knowledAf o codes and standards. <br />1kTA : EDER.ROOT <br />Set your s on us. <br />Name � R E BUST� <br />Sigirildure <br />Certification # <br />Ceraftation-Ueves* 1 <br />certlft"4110n Date 03/02/2002 <br />- See Reverse Side for Explanation of Levels <br />ROBERT BUSH <br />CALIF0 IAUST SERVICE TEC+49fdIAN <br />The individual named hereon ii'OERTIFIED-in-'the category shown, having <br />been so certified pursuant to succe4furEompietion of the prescribed <br />written examination. <br />Expiration date: Ju 28, <br />No. 5261103 -UT <br />Not valid <br />ICC certfficatiO'attests to competent knowledge of codes YiQf standards, <br />P, <br />"INROBERT BUSH <br />Ne <br />UNDERGkOUND STORAG!E��TK <br />INSTAL'LOON/RETRO <br />The individual named hereon is IST F a category shown, having <br />been SO certified pursuant to suc mpletion of the prescribed <br />written examination. <br />Expiration date: June <br />No.5261103-U1 <br />of valid unless <br />!CC certification attests to competent knowledge of coi:14,and standards, <br />ROBERT BUSH <br />UNDERGROUND STORAGE TANK 'C'0DECM1'+Z'1V <br />INSTALLATION/RETROFITTINLG <br />The individual named hereon is CERTIFIED in the category shown, having <br />been so certified pursuant to successful completion of the prescribed written <br />examination. <br />Expiration date: June <br />No. 5261103-U I <br />J <br />ilf 1 ed <br />Aof valid LnAZ by holder. <br />edge <br />of, by <br />:.d' fic"' <br />ICC certification attests to competent know edge of codes and standards. <br />
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