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COMPLIANCE INFO_2020
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PICCOLI
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1990
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2300 - Underground Storage Tank Program
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PR0231820
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COMPLIANCE INFO_2020
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Last modified
3/8/2021 9:27:37 AM
Creation date
6/18/2020 9:46:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231820
PE
2361
FACILITY_ID
FA0003826
FACILITY_NAME
Supervalu
STREET_NUMBER
1990
Direction
N
STREET_NAME
PICCOLI
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10121001
CURRENT_STATUS
01
SITE_LOCATION
1990 N PICCOLI RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Appendix XIII <br />Underground Storage Tank <br />Designated UST Operator Visual Inspection Report <br />FACILITY INFORMATION <br />CERS ID 1018455 Inspection Date 12/4/20 <br />Facility Name uNFI <br />Facility Address <br />1990 Piccoli Road <br />City <br />Stockton <br />ZIP Code <br />95367 <br />DESIGNATED UST OPERATOR INFORMATION <br />Name of Designated UST Operator <br />Erik Brown <br />Phone <br />209-470-7378 <br />ICC Certification <br />8883731 <br />Certification Expiration Date <br />6/15/22 <br />COMPLIANCE ISSUES <br />None <br />CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br />I hereby certify that the visual inspection was performed in compliance with California Code <br />of Regulations, title 23, division 3, chapter 16, section 2716 and all information provided <br />herein is accurate. <br />Designated UST Operator Signature <br />C.'--'' ,5•2-BL4)-PL- <br />Date Inspection Report Provided to Owner <br />12/4/20 <br />CERS = California Environmental Reporting System, ICC = International Code Council, ID = <br />Identification, NA = Not Applicable, UDC = Under-Dispenser Containment, UST = Underground <br />Storage Tank <br />Page 1 of 4
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