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COMPLIANCE INFO_2021
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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420
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2300 - Underground Storage Tank Program
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PR0231906
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
1/12/2022 4:38:57 PM
Creation date
1/11/2021 9:57:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231906
PE
2361
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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ilk <br /> California <br /> INTERNATIONAL <br /> CODE COUNCI <br /> Candidate ID: #####5558 <br /> Name : RHOME DESBIENS Date : 1 /4/2019 <br /> Address: PC) BOX 533 <br /> W SACRAMENTO CA 95691 ,.0933 <br /> EXAMINATION RESULT : PASS <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. Generally , ICC <br /> certificates are current for two years; check with your state for expiration periods in your state . <br /> You may request a wall certificate from ICC as well . This certificate will be provided at no cost to you , if <br /> you request it within 50 days of your exam . C)nly one wall certificate per exam passed will be provided to <br /> you at no charge . For more information on requesting a wall certificate , go to www. iccsafe , ora/insoe 4 <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 IGC at certexamQccsafe Iom with changes to your name and address ( name <br /> changes may require additional documentation) . There may be an additional fee if a certification is <br /> reissued due to a misspelled name or incorrect address . <br /> The authenticity of this scare report can be validated by using Pearson VUEt Online Score Report Authentication found at: <br /> www Pea�onyUE rom/ei,chent'=9 <br /> Digital embossing enm}nates the possibility of unauthorized embossing of counterfeit score reports . <br /> 778971293 <br /> (registration Number.& Validation Number: <br /> t <br />
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