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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0526212
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
8/4/2021 1:58:42 PM
Creation date
2/25/2021 4:42:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0526212
PE
2351
FACILITY_ID
FA0017737
FACILITY_NAME
CHEVRON STATION #307709*
STREET_NUMBER
10858
STREET_NAME
TRINITY
STREET_TYPE
PKWY
City
STOCKTON
Zip
95219
APN
06602015
CURRENT_STATUS
01
SITE_LOCATION
10858 TRINITY PKWY
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\kblackwell
Tags
EHD - Public
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836 Maintena C Division <br /> 30 Main Ave.,Suite 5 8281 Com.„ .,.,a <br /> Wayne Perry nc.- nye <br /> ....,�.�Commonwealth Ave, � r <br /> i <br /> Sacramento,CA 95 Buena Park, A 90621 S,% e ti 9 e S Job Ticket# NCA <br /> - 8635 Commerce Ave. Call 113: V 77 ZS-71 <br /> San Diego,CA 92121 <br /> SERVICE STATION MAINTENANCE RECORD <br /> Customer Name: 6ke i,� Date; J A/��Z�J�.J <br /> Contact Name: Job#NCM NFC: <br /> Station Address: !� O Ir+h1y ��+i LI.�'��� job#SCM/5FC: <br /> i - .,, <br /> City/Zip: �k'�1c'!�•� Job#N0/WA/OR: <br /> Facility 9: <br /> E <br /> Description of Work Performed: i +�► ��' E� CsB rat 1} Z lS.......__ `� ' 1 d��X11 ' ,,,....._ <br /> A4 . . PSL_ La.k.av rrJ�>,rt �;,c r,:- R <br /> n / n <br /> Is Job Complete? N if No,Comments: <br /> Testing Performed Y/N Circle One Test Results: GPM A/L-V/L Results <br /> j' rsonnel Time In RmnRatQ Hours <br /> ,F <br /> I <br /> Part# Part Description Vendor/Truck Qty Unit Price <<x <br /> s <br /> xxU .' <br /> 1wsS <br /> r l Labor Subtotal <br /> Travel Subtotal <br /> Authorized Signature Material Subtotal <br /> CDate ❑ Dealer Refused to Sign ❑ Co-Op ❑ Third Party <br /> �ttt1 tilt ltairttenac�ili d!, Warranty T&M Fixed Cost C.O.D. <br /> I' <br /> WHITE-Accounting • CANARY-Mai ntenance PINK-Customer � <br />
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