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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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KBlackwell
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EHD - Public
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Wayne Perry Inc. -Maintenance Division0, <br /> 30 Main Ave.,Suite 5 8281 Commonwealth Ave. <br /> Sacramento,CA 95838 Buena Park,CA 90621 1.6 job Ticket#NCA <br /> C 2" <br /> all ID: 6 <br /> SERVICE STATION MAINTENANCE RECORD <br /> Customer Name: Date: <br /> Contact Name: NFC/NCM: <br /> Station Address: t job#SFC/SCM: <br /> City/Zip: <br /> P.O./Notf.No.: <br /> Facility#: <br /> Descriptio rkPerformed: 'j1/)5+'A �( Q6-)*V\V,\ LJWJL"A &1 /v– 6A (AOC- <br /> f Wo <br /> 00 PVI tA. 02 A_+I 6-q— <br /> /N Cilli 5—t'&Os ghDL i2l\0 P1 LQ <br /> Is Job Complete? y If No,Comments: <br /> r_ersonqed Time In Time Out Rate Hours Total <br /> —7 wo— <br /> Part# Part Description VendorjTruck Qty Unit Price 10–tAl <br /> Labor Subtotal <br /> Travel Subtotal <br /> AuthoriLdSijl Material Subtotal <br /> GRAND TOTAL <br /> Date ❑ <br /> Dealer Refused to Sign ❑ Co-op Third Party <br /> Lj <br /> Attach ALL RECEIPTS and M5-641 FORMS to tl-ds Maintenance Record! Warranty T&M Fixed Cost C.O.D. <br /> L <br /> WHITE-Accounting CANARY-Maintenance PINK-Customer <br />
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