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COMPLIANCE INFO_2013-2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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25651
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2300 - Underground Storage Tank Program
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PR0231628
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COMPLIANCE INFO_2013-2018
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Last modified
11/19/2024 1:51:14 PM
Creation date
6/23/2020 6:50:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2013-2018
RECORD_ID
PR0231628
PE
2361
FACILITY_ID
FA0003835
FACILITY_NAME
SMK CHEVRON
STREET_NUMBER
25651
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
Zip
95220
APN
00514120
CURRENT_STATUS
01
SITE_LOCATION
25651 N HWY 99
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231628_25651 N HWY 99_2013-2018.tif
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EHD - Public
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ENVIRONMENTAL>. <br />r <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />rejaphone: (209) 468-3420 Fax-, (209) 468-3433 Web: XA__"-sigc_Lv,otQ1ehd <br />RETURN TO COMPLIANCE CERTIFICATION <br />JUL r 2011 <br />M. R i i t +.. _ i #_. R +w.. ■ '" i .. i _ ....*. • -:.1 � i. <br />oil��i.• a <br />mg,ffraffrpT,w w Note: All EAD stavY time asSOCIMIKI W1113 Tall <br />billed at the current hourly <br />verifyingFor this certification to be completethe operator of the site must include: <br />9 A statement documenting what corrective actions were taken or will be taken for each violatio <br />* Copies of sample results/manifestshraining records/other appropriate paperwork, and/or pho 11 <br />corrections <br />Operator's certification <br />By: Avi <br />inspectij <br />i �, y w <br />Facility Address: <br />•i:. ,+ <br />I certify under penalty of law that: <br />1. I have corrected the violations specified in the Inspection Report from the abovementioned <br />inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR <br />EACH VIOLATION and I believe the information to be true, occuratO, and complete: <br />Photos <br />i.. f ■ .... ■... istatement <br />Name:3. 1 am authorized to submit this certification on behalf of the Respondent <br />4, 1 am aware that there are significant penalties for submitting false information, including the <br />possibility of a fine and/or imprisonment for known violations. (HSC 26191) <br />Title: yi <br />EH0 22.82-= Rev 08!11 <br />COOO/TOOO d2I03 KSX RTCOCCC60Z XV3 Nd CT:T CTOZ/t0/LO <br />
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