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COMPLIANCE INFO_1999-2005
Environmental Health - Public
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EHD Program Facility Records by Street Name
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FRANK WEST
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2300 - Underground Storage Tank Program
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PR0515365
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COMPLIANCE INFO_1999-2005
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Last modified
1/12/2021 10:06:56 AM
Creation date
6/3/2020 9:59:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1999-2005
RECORD_ID
PR0515365
PE
2361
FACILITY_ID
FA0012107
FACILITY_NAME
A TEICHERT & SON INC*
STREET_NUMBER
120
STREET_NAME
FRANK WEST
STREET_TYPE
CIR
City
STOCKTON
Zip
95206
APN
19342006
CURRENT_STATUS
01
SITE_LOCATION
120 FRANK WEST CIR
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0515365_120 FRANK WEST_1999-2005.tif
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EHD - Public
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INSTRUCTIONS FOR COM*L-ETI'NG FORM "C'. TANK INSTALLAT CERTIFICATION <br /> GENERAL INSTRUCTIONS <br /> . Each tank system must be in compliancewith the federal and state technical <br /> standards, contained In low and regulations, for teak and piping installation. <br /> Z This certification shall be completed by dish r the UST owner or representative. <br /> One certification is required for each teak system. This form shall be used,t <br /> rake the required certification. <br /> . Please type or print clearly all requested 4rk,f rrn tion (for printing, please use <br /> hard point writing instrument). <br /> . Submit the completed certification to the rn ri te Local Implementing Agency. <br /> 1. INSTALLATION, MARK ALL OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br /> INSTALLATION REQUIREMENTS ARE MET. <br /> flm OATH: THE TANK,OWNER OR AGENT SMALL, CERTIFY, BY SIGNINGE <br /> CERTIFICATION, THAT THE INFORMATION PROVI IS TRUE AND <br /> CORRECT, THE PERS E SHOULD BE PRINTEDUNDER T'1 <br /> SIGNATURE. <br />
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