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COMPLIANCE INFO_2001-2005
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231898
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COMPLIANCE INFO_2001-2005
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Last modified
6/10/2020 2:10:33 AM
Creation date
6/3/2020 9:43:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2001-2005
RECORD_ID
PR0231898
PE
2332
FACILITY_ID
FA0003966
FACILITY_NAME
SHARPE SITE/DEF LOG AGENCY
STREET_NUMBER
850
Direction
E
STREET_NAME
ROTH
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19802001
CURRENT_STATUS
02
SITE_LOCATION
850 E ROTH RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2332_PR0231898_850 E ROTH_2001-2005.tif
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EHD - Public
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2202 S. MILLIKEN AVE. • ONTARIO, CA 91761 Date: <br />—2 <br />(909) 988-8000 <br />Job# <br />P.O. # <br />CONTRACTOR: <br />ADDRESS: <br />JOB SITE: <br />ADDRESS: <br />DESTINATION: A.M.R. 2202 S. MILLIKEN AVE., ONTARIO, CA 91761 <br />DATE <br />TIME <br />PROJECTED TANKS <br />ORDERED BY: <br />LIC. NO. <br />TIME IN: <br />SPECIAL INSTRUCTIONS: <br />TIME 26 <br />OUT: <br />9;� �✓ <br />Services Rendered Cost <br />TANKS RECEIVED <br />_ Disposal Fee <br />QTY GALLONS F S* NET TONS <br />TOTAL <br />_ Extensive Loading Time <br />iso ❑ ❑ 14 <br />_ Disposal Fee with Permit <br />Soo ❑ ❑ .21 <br />550 ❑ ❑ .24' <br />_ Fiberglass Tank Disposal Fee Per Tank <br />: <br />X000 -12 n.❑ ❑ .44 <br />1000 - 6 f ❑ ❑ 61 <br />Fiberglass Delivered1500° <br />...:. 13❑ A7 <br />.. ..❑ .... <br />2000._. <br />❑ .97 <br />Bobtail Disposal <br />2500 ❑ ❑ 1.44 <br />- ''.. <br />®❑ <br />_ Cancellation Fee <br />400ti a7 <br />5000 ❑ ❑ 2.42 <br />w.;r; >j�o u. 'M®❑ �� t ��s'�r!,; <br />TOTAL CHARGES $ <br />7500 ❑ ❑ 3.26 <br />} &I' t3 #" <br />All fees incurred are r load unless s <br />per pacified. Tema are net 30 <br />90W p - El$ max.: <br />days, from date of invoice. Contractor's signature represents <br />� <br />W�.�� <br />acceptance of terms for payment, and confirms that tank removal <br />120 ❑ 4.93 <br />complieswith State laws. <br />NO.OF TANKS TOTAL NET TONS <br />CONTRACTOR'S SIGNATURE <br />*F -FIBERGLASS *S -*STEEL 105 <br />
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