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COMPLIANCE INFO_1989-2001
EnvironmentalHealth
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BENJAMIN HOLT
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2300 - Underground Storage Tank Program
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PR0231952
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COMPLIANCE INFO_1989-2001
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Last modified
9/13/2022 2:55:50 PM
Creation date
6/23/2020 6:37:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1989-2001
RECORD_ID
PR0231952
PE
2351
FACILITY_ID
FA0003712
FACILITY_NAME
CHEVRON STATION #94275*
STREET_NUMBER
2905
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09760004
CURRENT_STATUS
01
SITE_LOCATION
2905 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231952_2905 W BENJAMIN HOLT_1989-2001.tif
Tags
EHD - Public
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INSTRUCTIONS FOR COPLETING FORM "C": TANK INSTALLAN CERTIFICATION <br /> GENERAL INSTRUCTIONS <br /> 1. Each tank system must be in compliance with the federal and Mate technical <br /> standards, contained in law and-regulations, for tank arra p:-p :_nstallation. <br /> 2. This'certification shall be completed by either the UST owner or representative. <br /> 3. One certification is required for each tank system. This form small be used to <br /> make the required certification. <br /> 4. Please type or print clearly all requested information (for printing, please use a <br /> hard paint writing instrument). <br /> 5. Submit the completed certification to the appropriate Local Implementing Agency. <br /> 1. INSTALLATION: MART{ ALL OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br /> INSTALLATION REQUIREMENTS ARE MET, <br /> il. OATH: THE TANK OWNER OR AGENT SHALL CERTIFY", BY SIGNING THE <br /> CERTIFICATION, THAT THE INFORMATION PROVIDED IS TRUE AIt17,, <br /> CORRECT, THE PERSON'S NAME SHOULD RE PRINTED UNDER THE <br /> SIGNATURE. <br />
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