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COMPLIANCE INFO_2019
Environmental Health - Public
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PR0513910
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COMPLIANCE INFO_2019
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Last modified
6/19/2020 10:42:56 AM
Creation date
6/19/2020 10:35:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0513910
PE
2228
FACILITY_ID
FA0003743
FACILITY_NAME
CANEPAS LUBE & OIL
STREET_NUMBER
6220
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
08136004
CURRENT_STATUS
01
SITE_LOCATION
6220 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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Aboveground Storage Tank Assessment Certification <br /> CANEPA'S LUBE & OIL <br /> 6220 Pacific Avenue, Stockton, California <br /> This document was prepared for: Canepa's Lube&Oil <br /> Company name: Canepa's Lube&Oil <br /> Address: 6220 Pacific Avenue <br /> Stockton, California 95207 <br /> Tank/system identification: Waste Oil Tank <br /> Date of inspection(s)/assessment: 15 January 2019 <br /> Inspector name Rene M. Toth <br /> This report consists of 6 pages(not including Cover sheet, Table of <br /> Contents, Figures, Tables and Appendices) <br /> certify under penalty of law that this document and all attachments were prepared under my direction <br /> or supervision in accordance with a system designed to assure that qualified personnel properly gather <br /> and evaluate the information submitted. Based on my inquiry of the person or persons who manage the <br /> system, or those persons directly responsible for gathering the information, the information submitted is, <br /> to be the best of my knowledge and belief, true, accurate, and complete. I am aware that there are <br /> significant penalties for submitting false information, including the possibility of fine and imprisonment for <br /> knowing violations. <br /> William VanDerWall <br /> Engineer's name Signature <br /> C 62560 �pFESSIC�.. <br /> License Number < �1ANb �h <br /> 31 December 2019 <br /> r <br /> License Expiration <br /> 0 C 62,560 <br /> Professional Civil Engineer <br /> License Type CMI- Q� <br /> 3745 Main Street Unit A <br /> Address of engineer <br /> I <br /> Kelseyville, CA 95421 <br /> City,State Zip <br /> Rene M. Toth <br /> Inspector Name ig ature <br /> (If supervised by above) <br />
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