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COMPLIANCE INFO 1999 - 2001
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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PR0231136
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COMPLIANCE INFO 1999 - 2001
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Last modified
6/4/2019 4:35:51 PM
Creation date
11/5/2018 11:27:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1999 - 2001
RECORD_ID
PR0231136
PE
2361
FACILITY_ID
FA0003610
FACILITY_NAME
A&A GAS & FOOD MART
STREET_NUMBER
16
Direction
E
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13902001
CURRENT_STATUS
01
SITE_LOCATION
16 E HARDING WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
KBlackwell
Tags
EHD - Public
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ARCA,P.raducts Company �� WORK AC OWLEDGMENT A 7 9 414 9 <br /> VENDOR NAME DATE: ll <br /> Elite IV COntract <br /> ADDRESS 2536 inwin Dr. FACILITY#: �� AUTH#/JOB ORDER: <br /> Stockton, CA -962M <br /> CITY LOCATION: <br /> STATE,ZIP CODE <br /> f <br /> SERVICE REQUESTED: <br /> SERVICES ACTUALLY PERFORMED: <br /> ,,, l�rr,� • �7 i � L <br /> tV�''1 j7C.c,L fir.-_ � / --7�th/, IN Gr-, �l'�-,t,•--� <br /> v <br /> PARTS: <br /> NUMBER OF OF OF • TOTAL :•- <br /> • •UT TIME LESS MEAL TIME <br /> AM AM <br /> PM PM <br /> FOR NON-LESSEE i CONTRACT DEALER USE ONLY: FACILITY STAMP <br /> ❑ MAINTENANCE VENDOR (Attach white copy to invoice and mail to technician.) <br /> ❑ LIGHTING <br /> ❑ LANDSCAPING/ FLOOR /PEST CONTROL VENDOR <br /> ❑ FIXED COST(Dispensers, General Contractor, Signage) <br /> TOTALn <br /> PRINTED NAME OF DEALER r M <br /> OR STORE MANAGER/EMPLOYEE: DATE: <br /> SIGNATURE OF DEALER �. <br /> OR STORE MANAGER/EMPLOYEE: <br /> SIGNATURE OF DEALER (OR STORE MANAGER) DOES NOT OBLIGATE DEALER IN ANY WAY, NOR DOES IT SIGNIFY ANY APPROVAL OF WORK <br /> DONE. CONTRACTOR IS RESPONSIBLE FOR FILLING OUT THIS FORM AND OBTAINING SIGNATURE. <br /> APC-3316 (10-95) Distribution: White: -Attach to invoice Canary - Left at location Pink- Vendor's copy <br />
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