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.i 0 <br />-V(� 'T-ANK -- T21 E -.Ki, <br />LOC tiOn : ERNIE'S LIQUOR <br />4407 EAST WATERLOO ROAD <br />STOCKTON, CA 95215 <br />Facility #: <br />BILL TO: HENDERSON CONSTRUCTION CO. <br />Contact: JUAN <br />Tank Monitoring Well 0 <br />Stage ii Riser <br />MPD Dispenser Fill <br />Site Diagram <br />Work Order ®ate <br />99'02' 902 IFEB. 19199 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DIVISION <br />SAN joAQUiN VALLEY UNIFIED AIR POLLUTION CONTROL <br />ANNUALlNSPECTION RETEST <br />POSY CONSTRUCTION X FOR SALE IN <br />APDL_ # GDF # <br />Dispenser <br />REG = Regular <br />Waste Oil= WSTE <br />PLIES = Plus <br />Premium = PREM <br />0 Turbine <br />sup =Super <br />Supreme =-SPRM <br />00 Vents <br />DiSL = Diesel <br />Heating Oil = FUEL <br />4407 EAST WATERLOO ROAD <br />O/� `SVA SvA <br />R <br />. RF sGp QFC A FC A< <br />c ASL A�Ci �Ls RFC vs �'FC <br />S S� S QFC SGA ,yGp <br />REGULAR O� b/� <br />O � SVa FFG .o SGA a <br />DIESEL <br />SUPER CUs RFC `SGA Ric <br />SLA 4/S� <br />E: <br />STORE <br />a <br />a a <br />Comments: <br />- Y <br />Lockout Tagout Procedure Followed? (YIN) <br />Y <br />Location fully operational before leaving site? (YIN) <br />N!A <br />Turbines, leak detectors and dispensers checked for leaks? (YIN) <br />NIA <br />Station Attendant present for final inspection? (YIN) if Yes - - Name: <br />Purchase Order Contract # <br />Time of test TTechnician <br />Name Si nature License <br />4:00 PM PHIL ROOMS 90-1052 <br />PM: (707) 440 01.51 TANK-TEKENVIRONMENTAL CjORFCWATiON wWW.FANn=W:�eA+ <br />FAX (707) 446.6102 607 ELMIRA ROAD, #524, VACAVILLCi, CA 95687 PHIL QP+F1NKT€KI 4 <br />