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COMPLIANCE INFO_1994-2001
Environmental Health - Public
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JACK TONE
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2300 - Underground Storage Tank Program
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PR0505264
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COMPLIANCE INFO_1994-2001
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Last modified
7/28/2021 1:19:59 PM
Creation date
6/23/2020 6:56:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1994-2001
RECORD_ID
PR0505264
PE
2361
FACILITY_ID
FA0006672
FACILITY_NAME
FLYING J TRAVEL PLAZA #618*
STREET_NUMBER
1501
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
22811017
CURRENT_STATUS
01
SITE_LOCATION
1501 N JACK TONE RD
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0505264_1501 N JACK TONE_1994-2001.tif
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EHD - Public
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P C IF <br />INSTRUCTIONS FOR A FORM "C", 1'1�'' Wl A'tO 4 <br />GENERAL INSTRUCTIONS <br />1. Each tank system , iF - he in compliance with the federal and s,1,,Av technical <br />standards, contaim, sw and regulations, for tank and �,i'oiotj <br />2. This certification shall -gin completed by either UST owner or <br />3. One certifi,,-aflion �:: ad ik systeiis 710s to <br />make the requireG c*,, <br />4, Please type or print clearly a <br />hard p(;int writing int rjmer.- <br />5. Submit the cornpleled to the <br />1. INSTALLATION. IMARK ALL OF THE ITEMS HAT rHE <br />iNST ALLATe�"'),N , E'QUIREW, <br />If. OATH. THE TANK OONE-ER OR AGENT HALE C-1 <br />CERTIM,CATIONI, THA4 THE INFORMATIC',l <br />CORRECT. THE PERSON'S NAME SHOULD BE <br />SIGNATURE. <br />
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