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COGBANCPA (2)
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2500 – Emergency Response Program
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COGBANCPA (2)
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Last modified
4/14/2021 11:30:33 AM
Creation date
4/14/2021 11:19:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COGBANCPA
PE
2546
FACILITY_NAME
BNSF
STREET_NUMBER
720
STREET_NAME
B
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15529021
ENTERED_DATE
9/1/2020 12:00:00 AM
SITE_LOCATION
720 B. ST.
RECEIVED_DATE
9/1/2020 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\ymoreno
Tags
EHD - Public
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JEMILL., <br />www.htitankwash.corn • <br />//wol o <br />P Num8ER <br />CUSTOMER NAME AND ADDRESS OR TERMINAL <br />MPLETE NAME (S): LAST <br />PRO Cr HAULED OR OTHER RESIDUE (S) <br />IN TANK <br />I•1 il TANK WASH <br />16814 Packers Elay Rd. PLANT LAKENEAD, CA 96051• 9957 MEDFORD AVE., BLD0.11 1-530-238-8845 • <br />FAX (530) 238-6843 (510) 588-2009 • FAX (510) 566-2044 TRUCK NUMBER <br />EPA SCAL000040818 OAKLAND, CA 04803 <br />TRAILER NUMBER DATE <br />138624 <br />— <br />NUMBER OF VALVES <br />NUMBER OF FITTINGS <br />HOSES <br />CLEANED BY: ALL WORK INDICATED ABOVE COMPLETED <br />READY FOR RELEASE <br />CHECKED Err <br />TIME <br />SEWER CHARGE <br />TOTAL COST <br />9. Hit Tank Wash makes no guarantee with rieltp•OI of tha Can't:affront/hi of the washing process or the complete 3 elimination of all residue and Moisture <br />I <br />NSPECTION OF THE EQUIPMENT IS AGREED TO REMAIN THE RESPONSIBILITY Of THE OWNER OR AGENT and they dO nereby reheye and discharge HT/ Tana Wash of anr <br />feSpOnslbility. clams And ( <br />Wham/sof any kind whateekaver by any Parson 'Or damage. as a result of alleged improper or imcomolgri• cloaning of equipment HAVE READ AND UNDERSTOOD THE <br />ABOVE CONDITIONS. <br />ADRF=c ,•••• • <br />WORK ORDERED <br />WHO <br /> CY <br />9 7 Naru <br />CAME AS IS
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