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COMPLIANCE INFO_2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0526212
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COMPLIANCE INFO_2018
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Entry Properties
Last modified
7/21/2020 9:26:53 AM
Creation date
9/4/2018 1:38:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2018
RECORD_ID
PR0526212
PE
2351
FACILITY_ID
FA0017737
FACILITY_NAME
CHEVRON STATION #307709*
STREET_NUMBER
10858
STREET_NAME
TRINITY
STREET_TYPE
PKWY
City
STOCKTON
Zip
95219
APN
06602015
CURRENT_STATUS
01
SITE_LOCATION
10858 TRINITY PKWY
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Wayne Perry Inc -Maintenance Division <br /> 30 Main Ave.,Suite 5 8281 Commonwealth Ave. <br /> i <br /> Sacramento,CA 95838 Buena Park,CA 90621 s N c e +9 e e Job Ticket#NCA! <br /> 1 )) q Q <br /> CallfD: 70 327` l/ !�8 <br /> SERVICE STATION MAINTENANCE RECORD <br /> Customer Name: �—Oa " , I :l Date: <br /> Contact Name: NFC/NCM: <br /> Station Address: h le Job#SFC/SCM: <br /> City/Zip: c P.O./Notf.No.: <br /> Facility#: r ` g ' <br /> Description of Work Performed: /� AO Chas ?. Pians `^ ` C ieL.k-1-1 <br /> c3 Y. vn� SLk <br /> �2 <br /> Is Job Complete? { Y/)N If No,Comments: <br /> 'Personnel Time In Time Out Rate Hours Total <br /> p <br /> L K <br /> (A <br /> Part# Part Description VendorLTruckQty <br /> Unit Price Total <br /> V:4f i ; « l2 0--s- I l <br /> 6 .C)P-L(L �u 1lel o <br /> Labor Subtotal <br /> Travel Subtotal <br /> Authorized Signature Material Subtotal <br /> GRAND TOTAL <br /> Date ❑ Dealer Refused to Sign ❑ Co-Op ❑ Third Party <br /> Attach ALL RECEIPTS and MS-641 FORMS to this Maintenance Record! Warranty T&M Fixed Cost C.O.D. <br /> WHITE-Accounting • CANARY-Maintenance • PINK-Customer <br />
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