Laserfiche WebLink
psi <br />• 0 <br />ecovr= eeni 1ceT <br />Type of Businem Or Property <br />-- - - <br />FACILITY IDS <br />SERVICE REQUEST II <br />iC,003%o00 <br />Mini Mart/Service Station <br />OOCJD <br />rI <br />Buse+Ess NAMEea. <br />Oil Equipment Service <br />BUM PAM O <br />ONMER I OPERATOR <br />RE <br />AUG 7 ZWZ <br />FAX S <br />Woolsey Oil Company_ <br />STATE A LP 95249 <br />San Andreas <br />FAc tm NAME <br />Norms 76 <br />WaPECTWiS SXiNAT11RE: <br />SITE ADORM E <br />Victor Rd. <br />AaPROwED ey: <br />633 <br />EwLOTE t ; Z, ? <br />Maillnq Address (It Different km SM Address' <br />OATS: <br />Assw o w: <br />CRY <br />STATE ZIP <br />CA 95240 <br />Lodi <br />DATE: <br />Date sa<vio Completed QT airoedy coag debd): <br />PHONE 111 saR. <br />APN d <br />LAm UsE Am nrATM <br />PHONE 02 <br />BOS Dwr=T <br />C00s <br />P"mentTyPe 1/ <br />Ipvalt� S <br />Check • 7 7 <br />6 -c� <br />BILLING : L ft undersOW property of busttwe o"w, OWOW or al &Odnd equd of soon. "WO* W d sb w4W POW sProw <br />PUBLIC HEALTII SER US ENVII WWAL HEALTH ON1M hourly dwgee sfeOGWW wo tkp*d or Its * wi be ODed b ore or o7 budeeee =-I w on *b bm. <br />I abo =* that I haw the and rtst ft psriom 14 M be done in Kw dam with d SAN JOA" COWO OMbM Codas Sbndh* STATE end <br />FBOEAAL laws. <br />t�Tt E. DAM, 8/21/02 <br />Amwwr <br />PNOMTy0 OPMMR / MANAGER O On*R AUT iORM AGWr <br />rArwrewrr.asr PodOf -9 1 0 loap.M-"Ni rltl. <br />AUTHORUMN TO RELEASE VWORMAMN: What epplobis L stn owner or openMor d tln property bceled d fw above sb addna, hasby &*win tln NIOM d <br />wsy and M nwks, 9e0-ad'd= w dlbr wmkom wit V&% allww It l 10fmtdan b an SAN JOOM COLUN AuetlC HULTH Sato= Ewaww Km HEALTH NOW as 900n <br />— A V ."b" —i at N,..am &. it to ninided in me or im mmaee O&L <br />TYPE OFSmrmREGt1ESTID: <br />Ba M PAWb <br />REQWWOR <br />CownENrs: <br />Keith A. Tallia <br />Buse+Ess NAMEea. <br />Oil Equipment Service <br />wS <br />201 754-1808 <br />MAs.aa ADOR>iss . <br />RE <br />AUG 7 ZWZ <br />FAX S <br />Cm <br />STATE A LP 95249 <br />San Andreas <br />BILLING : L ft undersOW property of busttwe o"w, OWOW or al &Odnd equd of soon. "WO* W d sb w4W POW sProw <br />PUBLIC HEALTII SER US ENVII WWAL HEALTH ON1M hourly dwgee sfeOGWW wo tkp*d or Its * wi be ODed b ore or o7 budeeee =-I w on *b bm. <br />I abo =* that I haw the and rtst ft psriom 14 M be done in Kw dam with d SAN JOA" COWO OMbM Codas Sbndh* STATE end <br />FBOEAAL laws. <br />t�Tt E. DAM, 8/21/02 <br />Amwwr <br />PNOMTy0 OPMMR / MANAGER O On*R AUT iORM AGWr <br />rArwrewrr.asr PodOf -9 1 0 loap.M-"Ni rltl. <br />AUTHORUMN TO RELEASE VWORMAMN: What epplobis L stn owner or openMor d tln property bceled d fw above sb addna, hasby &*win tln NIOM d <br />wsy and M nwks, 9e0-ad'd= w dlbr wmkom wit V&% allww It l 10fmtdan b an SAN JOOM COLUN AuetlC HULTH Sato= Ewaww Km HEALTH NOW as 900n <br />— A V ."b" —i at N,..am &. it to ninided in me or im mmaee O&L <br />TYPE OFSmrmREGt1ESTID: <br />Service <br />Station Retrofit inspections <br />CownENrs: <br />r <br />pEI E -S <br />RE <br />AUG 7 ZWZ <br />pACIUIN COU CES <br />Spu c NEAT- SER DIVISION <br />" <br />ENVIRONMENTAL NEAITH <br />WaPECTWiS SXiNAT11RE: <br />CONTRAGTbR'a SwNATtIRc <br />Keith A. Tallia <br />AaPROwED ey: <br />EwLOTE t ; Z, ? <br />OATS: <br />Assw o w: <br />EWLOYU * �� $ O <br />DATE: <br />Date sa<vio Completed QT airoedy coag debd): <br />1fEltylcE CGoo ... Q <br />P I E <br />F*e Amount <br />Amount Paid ,2 <br />t Dam ! " <br />P"mentTyPe 1/ <br />Ipvalt� S <br />Check • 7 7 <br />6 -c� <br />Rec&ed By: <br />