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COMPLIANCE INFO_1991-2004
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2300 - Underground Storage Tank Program
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PR0232534
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COMPLIANCE INFO_1991-2004
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Last modified
11/19/2024 10:19:32 AM
Creation date
6/3/2020 9:57:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1991-2004
RECORD_ID
PR0232534
PE
2361
FACILITY_ID
FA0004547
FACILITY_NAME
CHEVRON STATION #201383
STREET_NUMBER
1960
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23402001
CURRENT_STATUS
01
SITE_LOCATION
1960 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232534_1960 W ELEVENTH_1991-2004.tif
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EHD - Public
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INSTRUCTIONS FOR COMPLETING FC'r NI "C"; TANK W TALLAT"I li CERTIFICATION <br />NERAL INSTRUCTIONS <br />Each tank system must Ite In compliance vlh the federal and state technical <br />standards, contained in lair and regulations, f r teak and piping installation. <br />. This certification shall be completed by ef1fier the UST owner or representative. <br />. One certification is required `;-jr each lkan .y s gym. This form shall be used to <br />make the r uir dr if Corti `�.'. <br />4. please type or print 1*, _v -AP� �� � � .:. <rti r� {for printing, please use <br />hard point writing instrumento. <br />5Submit the completed certification to the appropriate Local Implementing Agency. <br />L INSTALLATION: L OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br />INSTALLATION REQf T ARE MET. <br />If. OATH: THE TANK OWNER OR AGENT SHALL CERTIFY, BY SIGNING THE <br />CERTIFICATION, THAT THE INFORMATION PROVl IS TRUE AND <br />CORRECT. THE ES 'S NAME SHOULD PRINTED UNDER THE <br />SIGNATURE, <br />
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