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COMPLIANCE INFO_1986-1996
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HARLAN
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16500
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2300 - Underground Storage Tank Program
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PR0231554
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COMPLIANCE INFO_1986-1996
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Last modified
4/28/2021 1:11:04 PM
Creation date
6/3/2020 9:50:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1986-1996
RECORD_ID
PR0231554
PE
2361
FACILITY_ID
FA0005678
FACILITY_NAME
LATHROP SHELL
STREET_NUMBER
16500
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
16500 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
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FilePath
\MIGRATIONS\UST\UST_2361_PR0231554_16500 S HARLAN_1986-1996.tif
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EHD - Public
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r rt <br />TANKNOLOGY9 <br />TECHNOLOGY FOR TANKS <br />AND THEIR ENVIRONMENT <br />Cust. PO# TEST DATE , <br />Tank , <br />Owner <br />Owner <br />Address <br />Owner <br />Name <br />Owner <br />Phone <br />FAX No. <br />EXACT LOCATION Facility # S <br />• <br />Service Order Agreement <br />VacuTect TM Leak Detection <br />Reg: 990, 9919 9929 993, 9949 995, 996. <br />Circle One <br />�3 Acc't. Cust. # <br />Invoice <br />Invoice <br />Address . <br />� 'o x'14 <br />Invoice <br />Contact 44' <br />Invoice <br />Phone <br />FAX No. <br />SCHEDULED START DATE I- <br />Start Time: ,�a Uo End Tims:. <br />Ap7'1!a% <br />bie Specifications: 71 <br />"'' Lb's <br />Unit # 4.3Z Testers Cert. # Agent SOi 0 8 4 0 4 4 <br />Taxable: Message: <br />TANKS TESTED <br />Tank 1: Size _ Product -u ZV <br />Tank <br />2: Size <br />Product <br />Tank <br />3: Size <br />Product <br />Tank <br />4: Size <br />Product <br />Tank <br />5: Size <br />Product <br />Tank <br />6: Size <br />Product <br />Tank <br />7: Size— - <br />Product <br />Tank <br />8: Size <br />Product <br />Tank <br />9: Size <br />Product <br />Tank 10: Size <br />Product <br />Line <br />Line <br />Line <br />Line <br />Line <br />Line <br />Line <br />Line <br />Line ! <br />Line 1! <br />Site Survey: s <br />Helium Leak Detection Service: <br />PARTS INSTALLED: Quantity <br />Other Parts <br />Installation Labor. <br />7 <br />Model Red Jacket Leak Detectors <br />iLEAK DETECTORS <br />Pass/Fail <br />Leak Det Test <br />Leak Det Test <br />Leak Det Test <br />Leak Det Test <br />*k Det Teat <br />Look Det Test <br />Wk Det Test <br />Leak Det Test <br />Leak Det Test <br />Leak Det Test <br />TANKNOLOGY is authorized to make and will be paid at its commercial rate for Making any minor adjustments and <br />repairs to piping and valves necessary. See Standard Terms and Conditions on the reverse side, which are Incorpo- <br />rated herein by reference and which are included as part of this agreement. By signing this agreement, you ac- <br />knowledge you have read, understand and agree to the terms and conditions on the reverse side of this agreement. <br />ACCEPTED BY: TANKNOL0flM4ERVICE DIVISION <br />Name:% l v / Name: <br />Title: Title: <br />For i4 Signature: <br />/Customer j <br />Signature: Date: - <br />Date: Time: �� ��' State: License # <br />Printed in the USX <br />TANKNOLOGY CORPORATION INTERNATIONAL <br />5225 Hollister Street • Houston, Texas 77040.6294 • 800-888-8563 • Fax: (713) 690.2255 <br />TAK-03 <br />CUSTOMER <br />
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