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INSTALL_2021
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CAROLYN WESTON
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2300 - Underground Storage Tank Program
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PR0546181
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INSTALL_2021
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Entry Properties
Last modified
4/17/2023 9:15:47 AM
Creation date
10/30/2020 4:28:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2021
RECORD_ID
PR0546181
PE
2351
FACILITY_ID
FA0026131
FACILITY_NAME
7-ELEVEN INC. #38616
STREET_NUMBER
601
Direction
W
STREET_NAME
CAROLYN WESTON
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
16422019
CURRENT_STATUS
01
SITE_LOCATION
601 W CAROLYN WESTON BLVD
P_LOCATION
01
QC Status
Approved
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SJGOV\kblackwell
Tags
EHD - Public
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3 <br /> { <br /> f <br /> 1 <br /> TANK INSTALLATION CHECKLIST <br /> i <br /> , i ' , <br /> fs,: .: peifresol } .a� e ' tt ) I U1 <br /> adfcfa <br /> ' PDitlONgi NATES <br /> ,. . ... Y.15 : ..,, . . . . , , . , ,, : > <br /> Note any variations and/or deviations from <br /> instructions (arid attach written authorizations): <br /> ' W <br /> 1 <br /> 1 - <br /> I <br /> i <br /> 1 <br /> i <br /> i <br /> f <br /> { <br /> 1 a, <br /> .h=' <br /> ao .:v- <br /> :�tv �•,:��� ' IG . Y KESS": <br /> CONTRACTOR ; TANK`OWNER/REPRESENTAT#VE <br /> 1 _ <br /> I verify thatthis information is a true record of the installation of the tanks I verify thatthis inform�ion is a true record of the installation of the tanks <br /> I listed here . listed , and thaf I have received a copy of the Installation Manual <br /> and this Tank Installation Checklist. _ <br /> I <br /> Name : • " � Name : 2 <br /> J �',. .. cf <br /> Telephone : (11.6 29 Telephone: 559/241 -9182 <br /> Email L � l✓4'� ' �ii/,�. ld Email : jeremy . fredrichs@7 - 11 . com <br /> Address: 20Ne 10015 _ Address : <br /> ®x o21 &16)!?q <br /> J <br /> Signature: G J )� Signature : <br /> 09 <br /> 3 <br /> Date : Date : 8/ 17/22 <br /> TO INSTALLER : Aftertank installation, deliver the Installation Manual with the completed Tank Installation Checklist to the tank owner. Retain a copy of <br /> each for your records . <br /> TO OWNER: After installation, retain the limited warranty, the Installation Manual and completed Tank Installation Checklistforfuture reference and to <br /> facilitate any warranty claim , <br /> Aft ANk <br /> Z C L I X E RX E S® IMOG1119PP 7 <br />
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