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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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P
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PICCOLI
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1990
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2300 - Underground Storage Tank Program
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PR0231820
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
12/7/2021 12:07:40 PM
Creation date
10/21/2021 8:56:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231820
PE
2361
FACILITY_ID
FA0003826
FACILITY_NAME
Supervalu
STREET_NUMBER
1990
Direction
N
STREET_NAME
PICCOLI
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10121001
CURRENT_STATUS
01
SITE_LOCATION
1990 N PICCOLI RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
Tags
EHD - Public
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1990 N Piccoli Rd, Stockton, CA PR0231820 <br /> 11/08/2021 Program: UST <br /> PHOTO 2: <br /> The 09/07/2021 designated o erator_monthly re ort was not si ned/dated b the owner/operator <br /> DesignatesUnderground Storage Tank <br /> BATOR <br /> OWNER/OPE inspection Report <br /> umber the follow DESCUST operator Visual RIPTION OF FOLLOW-1P ACTION <br /> up actionsto correspond to appropriate compliance issues from Section 3. <br /> L <br /> `\ 6. OWNER/OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> �1 1 have reviewed the results of the designated UST operator inspection report and provided a <br /> description of the actionis)taken or to be taken to correct any compliance issues discovered. <br /> Name of UST Owner/Operator(print) <br /> UST Owner/Operator Signature Date Signed <br /> 7. INSPECTION HISTORY <br /> Has each follow-up action of Section 3 from the previous Designated UST Yes No NA <br /> Operator Inspection Report been completed appropriately? <br /> Attach documentation venoong appropriate service to this report.) <br /> 8. RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history report/log to this report. Yes No NA <br /> r <br /> monitoring system powered on and in proper operating mode? riach alarm since the previous inspection been responded to appropriately? ❑ rih documentation verifying appropriate service to this report) <br /> all containment sumps,that have had an alarm since the previous ❑ rlated UST operator inspection report,been responded to by a qualified <br /> e technician? <br /> &)Aft answers marked`No"must be described by the designated UST operator in Section 3, <br /> Page 2 of 4 <br /> VICKY VANG-LEE, EHS Page 2 of 2 <br />
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