Laserfiche WebLink
" CGRS <br /> SOLUTiOfVS bELIVEFlED <br /> GENERAL CONTRACTOR STATEMENT <br /> Effective 05/26/15,the State Water Resources Control Board requires that the signed general <br /> contractor's statement be received from all general contractors prior to formal notification of final <br /> ELD testing (NO EXCEPTIONS). <br /> By signing below,the general contractor acknowledges that; <br /> "No further ground penetrating work,including beautification requirements,atop or immediately <br /> adjacent to,the UST system are needed or will be performed after ELD testing is performed." <br /> General Contractor information <br /> Company Name/CA Contractor License#: LC Services <br /> Contact: Larry Carpenter <br /> Address: 3887 N.Valentine Rd., Fresno, CA 93722 <br /> Telephone/Email: 559-444-1730/hopevargas@lcservices.com <br /> Site Information <br /> Site Name: Grappa Market Shell <br /> Address: 710 N.Jacktone Rd, Ripon,CA 95366 <br /> Telephone: unknown <br /> County: San Joaquin <br /> CUPA Contact: San Joaquin County Environmental Health <br /> CUPA Email: ust@sigov.org <br /> Testing Company Information <br /> Name: CGRS, Inc. <br /> Technician Assigned/License#: Sergio L. Nunez/#06-1727 <br /> Signature <br /> General Contractor's Signature: <br /> r <br /> Name(print)::, <br /> Title: [ . A.] Date of Signature: <br /> 5444 Dry Creek Rd. Sacramento,CA 95838 T916-991-1100 F 915.991-1117 www.cgrs.com <br />