Laserfiche WebLink
Sep, 17. 2013 9:41AM <br />0 <br />219-5590148 <br />02/0212012 11;50 <br />No, 1,340 P. 6/6 <br />�SI1714 PAGE 01/06 <br />Agency Inspection Report Pax <br />(PIeas9 fAX In A" Agency Inspecilon Reports with or without correcilve actions) SEP I ` <br />DATE: FEB. 2r 2912 —.. Pages: LNVIROIVK <br />(lt?5udln� <br />�-` ALTH D�EPAR' <br />coves <br />TO: Permit Desk <br />FAX (925) 842-9585 or (925) 842=5560 <br />FROM: Station # 21099711714 Ripon DA <br />(Chevron Facility #) 1 (CSI #) <br />Phone Number: 209-599-01.9 <br />Print Manager Name: Panty Aguayo <br />M facility received the attache) check appropriately below : <br />Y Y � { � <br />0 NOV - Notice o f' Vi)lation: A documem Jgso�(i by a. Govemment or Lar -al Agency identifying a <br />vi.vlatiaa ox coalition that requires ii cotmutive action by a �pcclfipd date and inay requi,Xe payment of a <br />monetary fine Of peAaltya <br />LJ NTC - N0000 tO CoMplyt A doaummit issued by a Governnimi or Local Agmzy identifying a <br />vioiat:ioa or condition of 11-an-comphanre that requkres a cQueetive actiori by a specific date bt)t does not levy a <br />nr011a my fmc or pem Ity. <br />F Other 100% or ARY Govemmew or Local Agency document or conrmuuication (these include a <br />successfully passed inspection) <br />I have also notified my BD & RESH representative via phone andfor tax. <br />Name of BC: Diane Province <br />Name of RESH Specialist: Gerardo Aouna <br />Notes: <br />In addition to faxing in the (legible) inspection report, please place al copy of the notice <br />Into file Retail Faclllty Compliance Workbook under Section 9 "RFC lnapections". <br />Updated 7-59-2011 <br />TAL <br />AT <br />