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COMPLIANCE INFO_1985-1997
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231074
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COMPLIANCE INFO_1985-1997
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Last modified
3/1/2023 9:09:44 AM
Creation date
6/23/2020 6:40:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1985-1997
RECORD_ID
PR0231074
PE
2361
FACILITY_ID
FA0002541
FACILITY_NAME
7-ELEVEN INC #20632
STREET_NUMBER
4627
STREET_NAME
DA VINCI
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
11002003
CURRENT_STATUS
01
SITE_LOCATION
4627 DA VINCI DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231074_4627 DA VINCI_1985-1997.tif
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EHD - Public
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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM JUL I Q -!Zj <br /> ENVIRONMENTAL HEALTH <br /> �t=R�IIT/ ICES <br /> tac>iuCy, Ka.e! �.— '�L �`I Tawk I Sate Product <br /> a opv a <br /> Telephone: I 3-rr <br /> Person Filing <br /> lteporc At / � <br /> L hereby rectify wader penalty of perjury that all inventory variations for <br /> the above meaeioeed facility were within the allowable Limits for this <br /> 4uaeeee. (He is Columo 13of the Loveococy Reconciliation Sheet) <br /> QLsventocr vaciaeioas exceeded the aLLowable limits for this Quarter. L <br /> hereby certify wader penalty of perjury that Che source for the variation <br /> was noC due to as ueauChorited (leak) ccleiae. (Yea in Column 13 of Che <br /> Loveacary Reeooeiliation Sheet) ' <br /> [mist date, eaok /. and amkounc foc all variscioos that exceeded the <br /> allowable Limits. <br /> Dace Taok I Amoucc: <br /> 1. <br /> 2_ <br /> J. <br /> 4.. <br /> S. <br /> A,dditiooal daces/aaaouocN chap be eoneioued oo a separaCe -heeC of <br /> papec and aC(achcd. <br /> It the ■oucce Of Che war t]( aon —I,tt t. r•r.-r,lrd .311t1v]h If IlotC3 v]3 du. CO <br /> • leak <br /> the knesden( stall be trp.ltcc-% ( .t I i I( [) t.n.ttconaten( ]t Ile.21 h <br /> vtChtn j(. hours and an un]u(h.ttitell t .- Ir.ls.• rrl.nrt subat(Ced. <br /> Lyle QuACCCCIy aumturr relsorC shall br A..bstC (Cd vtn 1) d]re of Che end (3( e.lcIt <br /> 7 u a r (r r ' <br /> QV a r C e f <br /> Qtaarter - October --> I)k-cr-et.cr <br /> Sena co: SAN JOAQU IN UICA1. HEAl.11; t)l NI'K ICT <br /> 16011- f. H. 7C I t 4641-.. l' .0 It<>x 11111'1 <br /> %Lock con , CA "15201 466 6 7b L <br /> �.0 In/110 <br />
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