My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO PRE 2016
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
W
>
WASHINGTON
>
1701
>
2300 - Underground Storage Tank Program
>
PR0501520
>
COMPLIANCE INFO PRE 2016
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/6/2020 4:40:46 PM
Creation date
11/7/2018 8:29:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2016
RECORD_ID
PR0501520
PE
2381
FACILITY_ID
FA0005133
FACILITY_NAME
CITY OF STOCKTON ENGINE CO #1*
STREET_NUMBER
1701
Direction
W
STREET_NAME
WASHINGTON
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
14510002
CURRENT_STATUS
02
SITE_LOCATION
1701 W WASHINGTON ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\W\WASHINGTON\1701\PR0501520\COMPLIANCE INFO PRE 2016 .PDF
QuestysFileName
COMPLIANCE INFO PRE 2016
QuestysRecordDate
9/6/2016 10:27:30 PM
QuestysRecordID
3183710
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
46
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
RECEIVE <br /> INVENTORY RECONCILIATION OCT 0 5 1992 <br /> QUARTERLY SUMMARY REPORT FORM ENVIRONMENTAL HEALTH <br /> Facility Name: C J4„Je &f)f 04)e- i Tank # i 40Mifi/5WWt <br /> o,Ue D a ;c <br /> Facility Address: /2v/ LJ. <br /> Telephone: S/G,- i �9 <br /> Person Filing/ <br /> Report: 3oh,J :K�/ /,v"/ 7 <br /> I hereby certify under penalty of perjury that all inventory <br /> variations for the above mentioned facility were within the <br /> allowable limits for this quarter. (No in column 13 of the <br /> Inventory Reconciliation Sheet. ) <br /> Inventory variations exceeded the allowable limits for this <br /> quarter. I hereby certify under penalty of perjury that the <br /> source for the variation was not due to authorized (leak) <br /> release. (Yes in Column 13 of the Inventory Reconciliation <br /> Sheet) . <br /> List date, tank #, amount for all variations and the reason <br /> for exceeding the allowable limits. <br /> Date Tank Amount Reason <br /> 1. <br /> 2 . <br /> 3 . <br /> 4. <br /> 5. <br /> Additional dates/amounts shall be continued on a separate <br /> sheet of paper and attached. <br /> If the source of the variation which exceeded allowable limits <br /> was due to a leak, the incident shall be reported to Public <br /> Health Services of San Joaquin County Environmental Health <br /> Division, within twenty-four (24) hours and an unauthorized <br /> release report submitted. <br /> The quarterly summary report shall be submitted within fifteen (15) days of <br /> the end of each quarter. Circle appropriate quarter. <br /> Quarter 1 - January---------->March <br /> Quarter 2 - April ----------->June <br /> Quarter 3 - July ------------>September <br /> Quarter 4 - October --------->December <br /> Send to: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3420 <br /> EH 23 019 (10/89) <br />
The URL can be used to link to this page
Your browser does not support the video tag.