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COMPLIANCE INFO_2020
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0514125
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
4/9/2020 10:40:16 AM
Creation date
4/9/2020 9:14:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0514125
PE
2228
FACILITY_ID
FA0009997
FACILITY_NAME
COUNTRY CLUB SERVICE / BOB'S LUBE & OIL HOUSE
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
01
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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93127/291V TUE 16125 FAX IQ,�uVL/UDI <br /> CBG SK-SSL-bOX-23 Raymond GOme2 02/12/18 12:01 PAGE 1 <br /> RE-` 1j+� rx <br /> afe -Ween S stems, Inc. I °rd ' <br /> �x v <br /> 2600 N Central E:xpy, suite 200 <br /> Richardson, TX '19080 MAR 2 7 2018 <br /> CORPORATE: 800-669-574n <br /> 24 YR EMCRGENCYi 800-468-1760 ISafetty-Kloen) <br /> ROR5451011 NSA. ENV,RONMENTAREFERENCE; NSA. <br /> CUSTOt4ER4 8023038 Bobs Lube & Smog 75919699-1800360252 H71\11THH DEPARTMENT <br /> 1.403 Country Club Blvd ERVC WEEN: 2018-7 <br /> Stockton CA 95204-4910 SRVC DATE: 02/12/18 <br /> P11ONC 209-943-3633 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> 13022519 Bobs Lube s Smog <br /> 1403 Country Club Blvd <br /> Stockton CA 952,04-4910 <br /> PHONE 7.09943-3633 <br /> PURCHASE URUE;R# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVTCF/ TOTAL <br /> PRODUCT OTY UNIT I-RICE) TAX CHARGE <br /> 98800 AQI SERVICE NITH 6365 1.000 33u,d200 26.26 365.05 <br /> SIN 9030008 TAG 00098000SK09030008 CLEAN 1.00 SPENT 0.000 <br /> SERVICE TERq 12 NEER SCANNED YES <br /> 100001 FCC, FUEL SURCHARGE 1.000 12.4800 0.97 13.45 <br /> ----------------- -- <br /> TOTAL SERVICE/PRODUCTS 351.3000 27.23 378.53 <br /> TOTAL CHARGE 378.53 <br /> CREDI'CS 0.00 <br /> --------------- <br /> TOTAL DUE 378.53 <br /> --------------- <br /> UNPAID BALANCE THIS RECEIPT 378.53 <br /> Machine clean and good condition? Yes <br /> Lamp Assembly Condition Yes <br /> Decals in place and legible? Yes <br /> Fusible link installed Yes <br /> Emergency closing of lid unobstructed? Yeo <br /> Machine properly groun ed? Yea <br /> Local Phone No, Sticker Affixed to Mnchine Yos <br /> Spent: 5ol.vent meets ae..eptanco prit.oria'P Yos <br /> GENERATOR STATUS <br /> 0-27.0 Ib.+/month <br /> Customer certifies the (i) the above-named materials are properly <br /> classified, packaged, Marked and labeled, and are in proper condition <br /> for transportation ace rding to the applicable regulations of the <br /> Department of Transpor ation (ii) no material change has occurred <br /> either in the characte iatics of the wpate/material or in the process <br /> generating the waste/ teriel, and (iii) the above referenced <br /> Generator Status Is Cd rect, Customer agrees to pay the abQVe charges <br /> and to be bound by the terms and conditions (1) set forth In (a) etre <br /> Gonerol Terms and Gond tions provided separately to Customer or (h) <br /> any .9K agreement &iqnel by Customer and 5K, and (2) incorporated <br /> herein by reference, Inless otherwise indicated in the payment <br /> received section, SK 13 authorized to charge Customer's account for <br /> Lhis transaction. If C stonier fails to make payment when due, an <br /> mmouriL equal to the le ser of (1) 1,5% pr.r mo(jLh 1189 per annum) or <br /> Il0 the maximum amours allowed by lnw, will be added Lu all unpaid <br /> amounts outatanding, C stomer certifies that the individual signing <br /> this Service Acknowled oment is duly authorized to sign and bind <br /> Customer. Customer ack iowledgea that it is responsible for maintaining <br />
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