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COMPLIANCE INFO_2012-2018
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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14971
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2300 - Underground Storage Tank Program
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PR0231911
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COMPLIANCE INFO_2012-2018
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Entry Properties
Last modified
11/20/2024 9:21:33 AM
Creation date
6/23/2020 6:53:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2012-2018
RECORD_ID
PR0231911
PE
2361
FACILITY_ID
FA0000540
FACILITY_NAME
COUNTRYSIDE LIQUORS & GAS
STREET_NUMBER
14971
Direction
N
STREET_NAME
STATE ROUTE 88
City
LODI
Zip
95240
APN
06316025
CURRENT_STATUS
01
SITE_LOCATION
14971 N HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231911_14971 N HWY 88_2012-2018.tif
Tags
EHD - Public
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'0 <br />............ <br />:4 21111] Z4 '! 11 ](410411 �� I I <br />71! I fl <br />11,7 <br />M7, <br />/'-, [ " '1 2 5 2 0 '1 -) <br />ENVIRON <br />Note: AN EHD staft time associated with failing to comply by,#w abovs noted dates will be <br />billed at the current hourly rate. <br />For this certification to be complete,ft 0PeMt0r Of the aft must irdude: <br />A statenient doctvrledr a. what coffective, actions were taken or will be taken for each violation <br />COPM of SMVL% fesutWmardestsftaining recordsk1her appropriate papenNod� and/or photos ven(ymg corrections <br />Iftwcuon Date.- March 30, 2017 inspected By: AARON HANG <br />Facility Address: 14971 N HVVY 88, LODI <br />I certify under penalty of laWthat <br />1. 1 have cormded." violatiorm Spedfied in UM ihspecdon Repwt tom to above-mentioned inspection dais. <br />2. 1 ham personaffy Okanvned the lbilovoing documerdation submMed as PMof of compliance FOR EACI-1 VKXATION and <br />I befieve the inkrmation to be Um, accurate, and complete: <br />Photos -Pmwwork --�_fttement <br />.3. 1 am authorized to iubmit this certffication on behalf of the Respondent. <br />A 1 am awam that #*e are sigrifficant penaffw for sulswIft false intonyown, including the po"bilily of a fine and/or <br />imprisonnumt for known Violations. (HSC2519i) <br />Name-... �Rj 194VI., Sop* YkAft" <br />Signaturef <br />ZOO/ ZOO*d LZ60# <br />I E" LTH <br />IF i`jl` E I, "'�T <br />TF99ttSEGOZ LE:ZT LTOZ/SZ/tO <br />
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