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COMPLIANCE INFO_1984-1994
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2300 - Underground Storage Tank Program
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PR0231765
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COMPLIANCE INFO_1984-1994
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Last modified
12/20/2023 4:08:11 PM
Creation date
6/3/2020 9:52:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1984-1994
RECORD_ID
PR0231765
PE
2361
FACILITY_ID
FA0003600
FACILITY_NAME
Nella Oil #427
STREET_NUMBER
3300
STREET_NAME
WATERLOO
STREET_TYPE
Rd
City
Stockton
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
3300 Waterloo Rd
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231765_3300 WATERLOO_1984-1994.tif
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EHD - Public
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INSTRUCTIONS FOR COMPLETING FORM "C": TANK INSTALLATION CERTIFICATION <br /> GENERAL INSTRUCTIONS <br /> 1. Each tank system must !,�e In compliance, the federal and state technical <br /> standards, contained in law and regulationG, 1or tank and piping installation. <br /> 2. This certification shall be completed by 64ier the UST owner or representative. <br /> 3. One certification is required for each tank %yslern. This form shall be used to <br /> make the required certification. <br /> 4. Please type or print clepr!v nli requen-in,s.,; -',-Frnation (for printing, please use a <br /> hard point writing instrument). <br /> Submit the com <br /> .pfeted ceenif. <br /> tion to th%jaggrojdate Local Implementin"ency. <br /> I 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 IS TRUE AND <br /> CORRECT. THE PERSON'S NAME SHOULD BE PRINTED UNDER THE <br /> SIGNATURE. <br />
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