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COMPLIANCE INFO_2011
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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THORNTON
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15237
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2300 - Underground Storage Tank Program
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PR0517272
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COMPLIANCE INFO_2011
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Last modified
6/30/2020 10:41:44 AM
Creation date
6/23/2020 6:59:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2011
RECORD_ID
PR0517272
PE
2361
FACILITY_ID
FA0012979
FACILITY_NAME
FLYING J TRAVEL PLAZA #617
STREET_NUMBER
15237
Direction
N
STREET_NAME
THORNTON
STREET_TYPE
Rd
City
Lodi
Zip
95242
APN
02519014
CURRENT_STATUS
01
SITE_LOCATION
15237 N Thornton Rd
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0517272_15237 N THORNTON_2011.tif
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EHD - Public
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L C' <br />V_�o jc— <br />if. AN43 Put -!;,E f C IJE. C'c _JTH P, - J� <br />rix <br />M ................ MEM UST Installation/Retrofitting <br />11=10M <br />Name. NAHUM VALDEZ <br />Address: 4470 YANKEE HILL RD <br />STE 200 <br />ROCKLIN CA 95677 <br />Date: <br />Birth Date: <br />EXAMINATION RESULT: PASS <br />6/29/2011 <br />4/18/1979 <br />Congratulations! You have passed the above named examination. Your wallet card will be forwarded to <br />you by ICC within six weeks from the last day of the month in which you tested. This certificate is current <br />for two years. <br />You may request a wall certificate from ICC as well. Throughout 2011, this certificate will be provided at <br />no cost to you, if you request it within 90 days of your exam. Only one wall certificate per exam passed <br />will be provided to you at no charge. For more information on requesting a wall certificate, go to <br />www.iccsafe.org/inspector. <br />It is extremely important that you notify Pearson VUE and ICC of any changes in name and/or address to <br />avoid the possibility of your wallet card and/or certificate not being received. Please contact Pearson <br />VUE at 800-275-8301 and ICC at certexam@iecsafe.org with changes to your n . ame and address (name <br />changes may require additional documentation). There may be an additional fee if a certification is <br />re -issued due to a misspelled name or incorrect address. <br />JUN 3 0 2011 <br />_3,A3C,1 11 0vtz"; hu"Ol.; <br />. . . . . . . . . . . . . <br />
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