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COMPLIANCE INFO_2020
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231074
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COMPLIANCE INFO_2020
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Last modified
5/7/2021 12:50:49 PM
Creation date
5/15/2020 4:19:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231074
PE
2351
FACILITY_ID
FA0002541
FACILITY_NAME
7-ELEVEN INC #20632
STREET_NUMBER
4627
STREET_NAME
DA VINCI
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
11002003
CURRENT_STATUS
01
SITE_LOCATION
4627 DA VINCI DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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CGRS <br />i <br />SOLLJT10N5 DELIVERED <br />GENERAL CONTRACTOR STATEMENT <br />Effective 05/26/15, the State Water Resources Control Board now requires a signed statement from all <br />general contractors prior to final ELD testing. <br />By signing below, the general contractor acknowledges that: <br />"No further ground penetrating work, including beautification requirements, atop or immediately <br />adjacent to, the UST system are needed or will be performed after ELD testing is performed." <br />General Contractor Information <br />Company Name/CA License #: LC Services <br />Contact: Larry Carpenter <br />Address: 3887 N. Valentine Rd., Fresno, CA 93722 <br />Telephone/Email: 559-444-1730/larrycarpenter@lcservices.com <br />Site Information <br />Site Name: 7 -Eleven #20632 <br />Address: 4627 De Vinci Dr., Stockton, CA 95207 <br />Telephone: unknown <br />County: San Joaquin <br />CU PA Contact: San Joaquin County Environmental Health <br />CUPA Phone/Email: ust@sjgov.org <br />'esting Company Information <br />lame: CGRS, Inc. <br />echnician Assigned/License #: Sergio L. Nunez/#06-1727 <br />Signature <br />General Cont <br />Name (print): <br />Title;t l- <br />5444 Dry Creek Rd. Sacramento, CA 95838 T 916.991-1100 F 916-991.1177 www,cgrs.com <br />
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