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REMOVAL_2002
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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PR0231870
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REMOVAL_2002
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Entry Properties
Last modified
12/16/2020 3:40:35 PM
Creation date
11/4/2018 4:58:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
2002
RECORD_ID
PR0231870
PE
2361
FACILITY_ID
FA0003953
FACILITY_NAME
AT&T California - UE148
STREET_NUMBER
7717
STREET_NAME
ELM
STREET_TYPE
St
City
French Camp
Zip
95231
CURRENT_STATUS
02
SITE_LOCATION
7717 Elm St
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\ELM\7717\PR0231870\REMOVAL 2002.PDF
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EHD - Public
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TANK CLOSURE 1TiF1CA L lar FORM <br /> : a IPN 11 11 H!�!7111�A7nN <br /> euslHESs Na7.tl <br /> Sr �r <br /> C <br /> R - -7 ouT� �7 l <br /> 10+ <br /> eusNE-33Crry <br /> TANK �' �rFIkC- T OA <br /> � <br /> 500 <br /> _ <br /> 301 <br /> I <br /> SARK C'NKER Carr 7 C� <br /> I 1 r IMA7nN <br /> QxYgen <br /> Tank Y nammacle Vaocr <br /> Caner � C3arCOm <br /> (State Tank ll f aQpii�flief Tcp Cen[er �auom a¢ �I1 <br /> Tank Intersor f <br /> as here <br /> Atm p <br /> Reacings <br /> � � 4 <br /> Qn examination ai tt a tank, !xrity tt a tank is visuaity dee Tom?radu�sl�:dge-scale(tSsin, laky n3idual of tank-Intents},rns2ate and deJns. i ituther�rtfY l <br /> Mat t;te inferrnation�rcw+ded herein is true Ona aerate to tate Gest of my'cnawledge. s� i <br /> S AILS CR AF=ILtAT Gt OF CERi,FYING?ERSCN <br /> CcRT1FiER SSG raTUtiRE (l NO L7 <br /> NANAE(PRINT) <br /> C=P.T.FIER 4x Canitser is a rep2setzrative of he C lPA1�A: YES <br /> C :R TIFiF—R T}TLE sa'r Name of CUFAILA <br /> ACC ESS if cerai -s er' ather Start C:JPN A�he<:X agCroOdate dax aelaw: <br /> C.i f ❑ Carofied Irdu^s=ai hygienrst(C.-H) <br /> PHGNE Cerdled Safety Praressic"i(CSP) <br /> CA—_ <br /> CERTIFIED xu I C�RTIFIUTICN i+ME <br /> Q Cartiffed Mame Clemrst(C:.SC) <br /> Register--d=v+tanmental'Heaim Specalut <br /> Q Prafessienal Engineer(PEf <br /> Gass It Registered Environmen=t Assasscr <br /> i� CSt 3;i�nsed.�nrracor(warn har3rticc�s sz,cstan��raHcatei <br /> =rncus'be,as <br /> yPs E_ ,No 7h[:5 tank rrewieusty`,eld?ammatsle cr=meusatte matenaLS. 4 yes. Ste17 ank interior atmcspnere s.1ad"e�����' <br /> indicator prier to wcrx,eirg =r4uGe7 an Me=k- <br /> Cardner5 tank sanagement instnoru;Cr swap dearer.discasal aCl'[Cf, --q C: <br /> I <br /> w¢Y cf:h>s c,mf cj=a snarl ac:;mpany ase tank to the recicinglduQos2t 5c sty. <br />
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