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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0547866
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
1/18/2023 2:14:13 PM
Creation date
8/2/2022 7:42:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0547866
PE
1635
FACILITY_ID
FA0027283
FACILITY_NAME
SISIG NI GG #4UZ5277
STREET_NUMBER
1717
Direction
S
STREET_NAME
UNION
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
16904012
CURRENT_STATUS
01
SITE_LOCATION
1717 S UNION ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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DocuSign Envelope ID:03FB477F-37DD-4COB-827E-F8C817ABE377 <br /> ELisLins Sm PRODUCT LISTING <br /> S2rVIC2S <br /> PO Box 57731 • Salt Lake Citv. UT 84157-0731 • USA • Phone 801 262 1868 • Fax 801 262 2363 • www.TEi-LS.com <br /> Issued To: Custom Roto-Molding, Inc. <br /> 307 Evans Street <br /> Caldwell, ID 83605 <br /> USA <br /> Phone: 208-459-1944 <br /> Fax: 208-459-1890 <br /> Listing Number: 16928 Listed Since: 1997-04-14 <br /> Last Revision: 2019-09-20 <br /> General Plumbing — Potable Water Tanks <br /> Certification NSF/ANSI Standard 14— Plastics Piping System Components and Certification Mark: <br /> Standards: Related Materials <br /> Product Potable water tanks <br /> Description: <br /> Model Numbers: 230VT, 550VT <br /> Listing Conditions: 1. Product must be installed and operated in strict compliance with all 16928 <br /> applicable codes, laws, and regulations having the force of law. (not covered underA2LA <br /> 2. The unit must be installed, operated, and maintained in strict accredited scope] <br /> compliance with the manufacturer's instructions. <br /> •A.� vvv���r ' <br /> 20 September 2019 <br /> Alona A. MacGregor,TEi-Listing Services Directs 4000Date <br /> The TEi-LS RV Component Certification Program is a"Type 3"certification program,as <br /> defined in ISO Guide 67. <br /> This Product Listing covers only those products under contract with TEi-Listing Services.No <br /> ACCR ED alteration to this document is authorized.TErs trademark is registered and its use is by <br /> contract or written permission only.ABUSE and/or IMPROPER USE OF THE PRODUCT <br /> PRODUCT CERTIFICATION BODY VOIDS THE LISTING. <br /> CERT 42946.01 <br /> TEi-l5 Form L5307 Page 6 of 6 <br /> Revision 20120613 m 2012 Testing Engineers International,Inc'. <br />
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