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COMPLIANCE INFO_2008-2018
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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DE VRIES
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2300 - Underground Storage Tank Program
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PR0231547
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COMPLIANCE INFO_2008-2018
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Last modified
3/8/2023 3:48:09 PM
Creation date
6/23/2020 6:49:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2008-2018
RECORD_ID
PR0231547
PE
2361
FACILITY_ID
FA0003848
FACILITY_NAME
Verizon Business: KINGCA
STREET_NUMBER
13850
Direction
N
STREET_NAME
DE VRIES
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05524018
CURRENT_STATUS
01
SITE_LOCATION
13850 N DE VRIES RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231547_13850 N DE VRIES_2008-2018.tif
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EHD - Public
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Opp J... ;:. CQuecty <br />EhAtOitt ental. Health iaparitonC <br />1060: East Hazelton.AuenueStockton, CWomb 952aM32 <br />T, , <br />Apyvww violations noted the" dOc:e to Comply* in the attached Inspection Report must be ggMW gd within.3l) of <br />of finis insttee. Tttl.rertificat fsifm muiitbe submitiecl tonvironmentai Huh Department (>sHt)ads t <br />All co a lL ... V Iatkms noWd-16 the attached IhOpeotion,11epott, Rj of Conflnuad0n Form, 0 dlsput" to any, <br />violations, are to be submitted using this certification and returned to EHD'WfJa 3Q 4" unless ath"se spy a flad FhAhe <br />i`nspecfion Report. HSO°26 .t3;1p <br />All RHP -staff time associated With tailing to coibply by We above not6d dates will- be <br />billed at the cprrent,lhowrly ra% <br />For this Ql id 1Q ! %# Ct I1`i }�E E3, they oper ter orthe site tYtust inoi ide; <br />Aatat maht doaurnen ing vVtaat cixr ttv4 Minns wera takdn,,er will kse tatcetti for epch Aolatian <br />Copies cif sample results/mantrests/traininp reodrdst6ftr appropriate pa0er0irk, and/or photos verifying cotrectlorib <br />lnslpec Data; eptomber 03,E 2015 /nape By ARIS, Vi=LOSt <br />koll ty dlress 1IL50 N DF, VRIES RD, LODI 'EPA IM <br />i c3ernty unaer, penat y arraw tnar <br />1. I hava:correc d the ns s In the Inspeatlon RQpoit from the above-mentioned inspection date. <br />2. 1 have persotla y examined the following documatrtation submitted as proof of compliance FOR EACH VIOLA 1QN <br />I belleve the information Ao be true, arouretQand tnpJete, <br />, <br />Photos Paperwork tatement <br />3. 1 am authorized to submit this Certi%ation on behalf of the Respondent <br />4. lam awaree that there are significant penalties for submitting false information, including the posstbdiity of a fine sitd/` <br />imprisonment for known violations. (HSC 261PI)l <br />SEP 17 ZO <br />ENVIRONMENTAL <br />
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