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COMPLIANCE INFO_1998-2006
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231784
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COMPLIANCE INFO_1998-2006
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Last modified
12/4/2023 3:34:17 PM
Creation date
6/23/2020 6:52:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1998-2006
RECORD_ID
PR0231784
PE
2361
FACILITY_ID
FA0003834
FACILITY_NAME
PACIFIC AVE CHEVRON
STREET_NUMBER
6633
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
097-410-48
CURRENT_STATUS
01
SITE_LOCATION
6633 PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231784_6633 PACIFIC_1998-2006.tif
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EHD - Public
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INISTRUCTIONS FOR COMPLETING FORM "C": TANK INSTALLATION CERTIFICATION <br />GENERAL INSTRUCTIONS <br />10 Each tank system must be in compliance with the federal and state technical <br />standards, contained in law and regulations, for tank and piping installation. <br />2. This certification shall to completed by either the UST owner or representative. <br />1 One certification is reqUired for each tank system. This form shall be used to <br />make the required certification. <br />4. Please type or print cl . e arly I al 1 1 ru act ad inf a r;r afln for pr'In ting", please use a <br />hard pptnt writing instrument). <br />s, Subrnil ib e completed certification to the appropriate Local Implementing Agency. <br />I. INS11"ALILATION- INARK ALL OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br />INSTALLATION REQUIREMENTS ARE MET. <br />IL OATH: THE "I'ANK OWNER OR AGENT SHALL CERTIFY, BY SIGNING THE <br />eft RTIFIC,'ATION, THAT THE INFORMATION PROVIDED IS TRUE AND <br />CORRECT, THE PERSON'S NAME SHOULD BE PRINTED UNDER THE <br />SIGNA-IFURE. <br />
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