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COMPLIANCE INFO 2016 - 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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PR0516526
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COMPLIANCE INFO 2016 - 2018
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Entry Properties
Last modified
5/28/2019 2:27:51 PM
Creation date
10/19/2018 10:08:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016 - 2018
RECORD_ID
PR0516526
PE
2361
FACILITY_ID
FA0012659
FACILITY_NAME
LOVE'S COUNTRY STORES OF CALIF #223
STREET_NUMBER
1553
STREET_NAME
COLONY
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
24534024
CURRENT_STATUS
01
SITE_LOCATION
1553 COLONY RD
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
Scanner
KBlackwell
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EHD - Public
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Candidate ID: <br />Name: <br />Address: <br />UST instaliation / Retrofitting <br />ICCO0206418 <br />Nick brazzanovich Date:. 2/4/2015 oj' P—XP �r"( <br /> <br /> <br /> <br /> '7 <br />� // -/ <br />EXAMINATION RESULT: PASS <br />Congratulations! You have passed the above named examination. Your wallet card will be forwarded to <br />you by ICC -within six weeks from the last day of the month in which you tested. This certificate -is current <br />for two years: <br />You may request a wall certificate from ICC as well. This certificate will be provided at no cost to you, if <br />you request it within 90 days of your exam. Only one wall certificate per exam passed will be provided to <br />you at no charge. For more information on requesting.a wall certificate, go.to www.iccsafe.orgrrspector. <br />It is extremely important that you notify Pearson VUE and ICC of any changes in name and/or address to <br />avoid the possibility of your wallet card and/or certificate not being received. Please contact Pearson <br />VUE at 800-275-8301 and ICC at certexam @!ccsafe.org with changes to your name and address (name <br />changes may require additional documentation). There may be an additional fee if a certification is <br />re -issued due to a misspelled name or incorrect address. <br />RECEIVED <br />MAR 13 2017 <br />ENVIRONMENTAL HEALTH <br />DEPARTMENT <br />The authenticity of this score report can be validated by using Pearson VVE's Online Score Report A uthen tication found at: <br />www.PearsonVUE.com/authenticate <br />Digital embossing eliminates the possibility of unauthorized embossinv of counterfeit score reports. <br />Registration Number: 278290689 Validation Number. 907557382 <br />
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