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3000 – Underground Injection Control Program
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PR0515035
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Last modified
2/11/2019 4:08:16 PM
Creation date
2/11/2019 3:04:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
WORK PLANS
RECORD_ID
PR0515035
PE
3030
FACILITY_ID
FA0012021
FACILITY_NAME
WESTERN SQUARE INDUSTRIES INC
STREET_NUMBER
1621
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
1621 N BROADWAY AVE
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
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EHD - Public
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CERTIFICATION <br /> -- The following certification is included in this report as required by the USEPA Region 9 Guidelines <br /> for Closure of Shallow Disposal Wells - 1992: <br /> I certify under penalty of law that this document and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to assure that qualified personnel <br /> properly gather and evaluate the information submitted. Based on m_y inquiry of the person or <br /> persons who manage the system, or those persons directly responsible for gathering the information, <br /> I certify that the information submitted is, to best of my knowledge and belief, true, accurate, and <br /> complete. I am aware that there are significant penalties for submitting false information, including <br /> the possibility offine and imprisonment for knowing violations. <br /> Advanced GeoEnvironmental, Inc. Ea GfOr <br /> �g ��►E�nFgs��6 <br /> L, <br /> --4 <br /> Nuel C. Hen de son, Jr. <br /> Senior Project Geologist <br /> California Registered Geologist No. 5837 <br /> Advanced GeoEnvironmental.Inc. <br />
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