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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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15250
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2300 - Underground Storage Tank Program
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PR0537919
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
12/24/2020 1:26:17 PM
Creation date
7/20/2020 9:44:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0537919
PE
2351
FACILITY_ID
FA0021886
FACILITY_NAME
Love's Travel Stop #538
STREET_NUMBER
15250
Direction
N
STREET_NAME
THORNTON
STREET_TYPE
RD
City
Lodi
Zip
95242
CURRENT_STATUS
01
SITE_LOCATION
15250 N THORNTON RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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S!SrNR INC. _ <br /> $E VItC�E START ON NAME PHONE# STOREd JOB# <br /> BILL TO G"'{I� �Tr .5�. <br /> BILL TO ADDRESS SERVICE STATION ADDRt SS PQ#OR INCIDENT# <br /> REQUESTED B� <br /> t-d t:-A <br /> VJAS JOB COMPL ETED'� TECHNICIAN N <br /> HE PORTED PROBLEM Nr CODO CHARGE <br /> MATERIAL CHARGES '.. <br /> MATERIAL DESCRIPTION <br /> QTY. PRICE AMOUNT <br /> SERVICES/REPAIRS PERFORMED <br /> L 94.�2s't 2.0.. •' <br /> IM <br /> A � I � f ear � � s� � ��f i le A---d e"'r-- <br /> X3 r Q Ut C�d L' 'r l UL r c_' a <br /> YES NO <br /> 14 <br /> 4--e—p—e— L) � r,.� �.�„l ,,,�. WFRE CORES RECEIVED? <br /> hC,v l� V A r+ i TOTAL.MATERIAL <br /> +Y'G... t r SALES TAX ON TOTAL MATERIAL <br /> /1 TOTAL LABOR CHARGE <br /> TOTAL TRAVEL TIME fL""f_+ <br /> ^ C f TOTAL MILEAGE v a� L <br /> G FAULT ARRIVAL TI AT SITE <br /> }� y PM <br /> CAUSE DEPARTURE 1T1ME AM, <br /> _ 'r/ � V <br /> REMEDY TOTAL TIME ON SITE <br /> HRS MIN <br /> S VICE PERSON(PRINT AME) SERVICE PERSON(PRINT NAME) l AUTHORIZED PERSON(PRINT NAME) <br /> I. . ��fZ �1._..__ TOTAL r Cs1 "rC� <br /> ISE�V E PER N'S IGNATLI S RVIGE PERSON'5 SIG U E AUTHORIZEA,..E S N'S SIGNATURE DATE <br /> SAL:.S EEMENT-.Itis greed that,4 collection ruade by su4 or otherwise.liw agree to pay a FINANCE CHARGE(NOT 0 C ED THE MAXIMUM LEGAL RATE)computed after 20 days from the due dale on t'ie prcv ous balance after <br /> deducting c,+rent payments andfor credits Until f pard.Ilwe also agree to Fay all collections costs and,neludmy atoroeys fee, ray be adjudged ty the coat,and waive all rights at any c'iaams exempted under Stale I aws,and wtll not remove <br /> Voperty without prier wrMen consent of 5SSR,Inc fiom original plane of.services providedideliverylvnstallahon of parts Me-chandise not_returnab!e unless approved by BSSR lnc.(SELL ER) _ _ _ <br />
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