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INSTALL_2022
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2300 - Underground Storage Tank Program
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PR0518288
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INSTALL_2022
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Entry Properties
Last modified
1/18/2023 9:33:30 AM
Creation date
5/31/2022 1:10:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2022
RECORD_ID
PR0518288
PE
2351
FACILITY_ID
FA0013810
FACILITY_NAME
COSTCO WHOLESALE #658
STREET_NUMBER
3250
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
3250 W GRANT LINE RD
P_LOCATION
03
QC Status
Approved
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SJGOV\kblackwell
Tags
EHD - Public
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Wf/OLESALE <br /> RE: Agent Authorization for Barghausen Consulting Engineers, Inc. <br /> Costco Gasoline/Fuel Operations—Regulatory Compliance <br /> To Whom It May Concern: <br /> Costco Wholesale Corporation (Costco) hereby authorizes Barghausen Consulting Engineers, Inc. <br /> (Barghausen) and its designated personnel under its employment to act on behalf of Costco as it <br /> Authorized Agent on all matters pertaining to regulatory compliance for the operation of all retail <br /> gasoline/fueling facilities owned and operated by Costco in the United States. <br /> Costco and Barghausen have entered into a Service Agreementthat establishes the terms,conditions,and <br /> scope of services of this Agent Authorization granted to Barghausen. With this Agent Authorization, <br /> Sarghausen is granted signatory authority on all regulatory compliance materials and documentation. <br /> Costco further authorizes that all future regulatory compliance correspondence, notifications, and <br /> documentation be forwarded to the following address for further handling. <br /> Costco Wholesale <br /> clo Barghausen Consulting Engineers, Inc. <br /> 18215 72nd Avenue South <br /> Kent,WA 98032 <br /> Email:costco@barghausen.00m <br /> Please call me at(425)313-8100 with any questions on this matter. <br /> Res Ily, <br /> rght Larsen <br /> Director of Operations <br /> NOTARY <br /> On this V Yk day of March, 2021 before me, the undersigned, a Notary Public In and for the State of <br /> Washington, duly commissioned and sworn personally appeared OWQhy Lo X5&11 known to me <br /> to be the duly authorized representative of Costco Wholesale, the corporation that executed the foregoing <br /> instrument, and acknowledged said instrument to be the free and voluntary act and deed of said <br /> corporation,for the purposes therein mentioned,and on oath stated that he was authorized to execute said <br /> instrument. WITNESS my hand and official seal hereto affixed the day and year in the certificate above <br /> written. <br /> NpN1Eq �,rhrr <br /> (Signature) =4�a`.., <br /> ?a 289883 _' <br /> i a i n <br /> (Printed Name) (Seal) <br /> NOTARY PUBLIC in and forth e S State eon Washington residing at P/0 CK D rOmd nd �rrir�Oa1�;i;ASH`a�.�� <br /> My commission expires: <br /> 999 Lake Drive • Issaquah, WA 98027 • 425/313-8100 • Fax 425/427.7133 • www.casko.mm <br />
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