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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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2200 - Hazardous Waste Program
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PR0518181
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COMPLIANCE INFO_PRE 2019
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Last modified
10/1/2020 3:34:55 PM
Creation date
10/1/2020 3:10:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0518181
PE
2220
FACILITY_ID
FA0003610
FACILITY_NAME
A&A GAS & FOOD MART
STREET_NUMBER
16
Direction
E
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13902001
CURRENT_STATUS
01
SITE_LOCATION
16 E HARDING WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\dsedra
Tags
EHD - Public
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ARCO Products Company WORK ACVNOWLEDGMENT <br /> A915552 <br /> VENDOR NAME ir§�n DATE:__L�L <br /> ADDRESS ND j.�) FACILITY#: S-4 AUTH#/JOB ORDER: <br /> LOCATION: f,'2 <br /> < <br /> STATE, ZIP CODE <br /> SERVICE REQUESTED: <br /> SERVICES ACTUALLY PERFORMED:.T---tn,-)P-�t;:7-f) 00OF— CAD i U'_ U_ <br /> 7 <br /> ers: <br /> 49 <br /> NUMBER OF ARRIVALS AS OF TOTAL TRAVEL LESS MEAL TIME TOTAL LABOR <br /> PERSONNEL CHECKIN TIME <br /> AM AM <br /> P <br /> PM M <br /> FOR NON-LESSEE CONTRACT DEALER USE ONLY: FACILITY STAMP <br /> El MAINTENANCE VENDOR (Attach white copy to invoice and mail to technician.) <br /> ❑ LIGHTING <br /> El LANDSCAPING / FLOOR PEST CONTROL VENDOR <br /> El FIXED COST(Dispensers, General Contractor, Signage) <br /> TOTAL <br /> F,RINTED NAME OF DEALER <br /> OR STORE MANAGER/EMPLOYEE: DATE: <br /> SIGNATURE OF DEALER <br /> OR STORE MANAGER/EMPLOYEE: <br /> SIGNATURE OF DEALER (OR STORE MANAGER) DOES NOT OBLIGATE DEALER IN ANY WAY, NOR DOES IT SIGNIFY ANY APPROVAL OF WORK <br /> DONE. CONTRACTOR IS RESPONSIBLE FOR FILLING OUT THIS FORM AND OBTAINING SIGNATURE. <br />
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