Laserfiche WebLink
Parkwood Gas& Food 2098888157 p.14 <br /> 41.6 2nd Street <br /> J fforda-le Galt, CA 95632 <br /> st (209) 744-0113 Fax (209) 744-0116 <br /> E.O. VR-204 <br /> Veeder- oot In-Station Diagnostics Site Shutdown Test Report Form <br /> Permit Number:N97-1-15 Date of Test: 09-12-17 Time: 930 <br /> Site Name: TIWANA GAS &FOOD VALERO <br /> Site Address: 1210 HAMMER LANE ; x <br /> City- STOCKTON CA Zip: 95213 Technician: FELIX RAMIREZ <br /> Veeder-Root: B34976 <br /> District: SJVAP NORTH <br /> kk <br /> maimfin'' ( �.1 a.M <br /> Was power removed from the TLS-350 console? YES <br /> Was power to the submersible pump(s)removed by the TLS-350? YES <br /> Was power restored to TLS-350 console? YES <br /> NOTES: lA certified Veeder-Root technician must perform this test. <br /> I declare, under penalty of perjury under the taws of the state of California that based on information and belief formed <br /> after reasonable inquiry, the statements and information provided in this document are true, accurate, and complete. <br /> Signature of Technician: Date: 09-12-17 <br /> h; - <br /> t S <br /> Hbti <br /> gam.aat s.-.y� <br /> a 4 <br /> e'er. 1.0 'o9.1'i s <br /> Received Time Jul. 25. 2018 10:46AM No- 3918 <br />