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COMPLIANCE INFO_2012-2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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2575
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2300 - Underground Storage Tank Program
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PR0231070
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COMPLIANCE INFO_2012-2018
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Last modified
2/22/2023 4:20:12 PM
Creation date
6/3/2020 9:43:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2012-2018
RECORD_ID
PR0231070
PE
2351
FACILITY_ID
FA0006439
FACILITY_NAME
COUNTRY CLUB MOBIL CIRCLE K
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231070_2575 COUNTRY CLUB_2012-2018.tif
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EHD - Public
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r DE�-12-2006 04:33P FROM:MVP PE QOLEUM ENGINE 916 984 -1117 :19259790467 P.2 <br /> UNIFIED PROGRAM CONSO <br /> LIDATED FORM <br /> TANM <br /> EGO STORAGE TAN -INSTALLATION <br /> CERTIFICATE OF CONK+ ANCE <br /> (Ompw pw u* <br /> I.FACILITY MM rMICAT1014 <br /> BUSNANEtmm.�Reaottu�art� of <br /> ADDR�"S(Firtow�o� <br /> e <br /> FAC <br /> t TAN m a <br /> IL WSWA ATIOW <br /> (Cte�c•1l ihtt . <br /> The indallef has been twined end axtified by the tank MW pipinS nm .a <br /> The infalletion has been i and certified by a prof=Wonal engineez hung edu adon and <br /> with underground stantge tank haMllatimm "' <br /> The indallsdon has been in and "'d by the Unifies PWwn A 4a <br /> Agency. <br /> { All work lided on the mann 'a tnsdtlladon cheMist has beasta' <br /> colttpleted. <br /> 7be insetller has bean certified or licamed by the 'State License Board. +a. <br /> The and OMW tank, amort pipiA& and <br /> s contai t ted M <br /> 's talion '� to applicable <br /> Dearipflan of work bft crd fie&; <br /> III.TAM OWralt/AMW SIGNATURE <br /> t ewtity.dia idea hit Is ma and amnft to the b m of aw kwwWg,*. <br /> SIG OF AOt'dV1 <br /> DAT <br /> N QF OwNBR/AQBNT Wkd) <br /> 14 1/ TPTLB F Q ER/AGEW <br /> UPCP(t/94)tiwfwr"-14 http:uwww.amNdom&rg <br /> Rev,tlx/1�p <br />
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