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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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AIRPORT
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2300 - Underground Storage Tank Program
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PR0521942
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
8/18/2022 9:49:50 AM
Creation date
5/24/2021 10:32:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0521942
PE
2371
FACILITY_ID
FA0014921
FACILITY_NAME
RANCHO SAN MIGUEL MARKET*
STREET_NUMBER
1427
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
16902016
CURRENT_STATUS
01
SITE_LOCATION
1427 S AIRPORT WAY
P_LOCATION
02
P_DISTRICT
001
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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p <br />ae�E <br />Contractor License: 485184 <br />The status of this task is: <br />Work Order <br />Job: 404403 <br />PO#: Quote 100657 <br />Ref#: <br />CLOSED -COMPLETE Brief Summary of Repairs or Additional replaced damaged <br />Details: bucket ran bucket test <br />Category: Tanks -Lines <br />Unit#: 01 <br />Component: Fill Bucket <br />Component: Fill Cap <br />Item : TANK <br />Serial#: <br />Failure: Damaged -Worn <br />Serial#: <br />4/02/2021 Misc Safety Equipment <br />Repair: Replaced Same Model <br />Task#: 6 <br />1.00 <br />Enter Date/Time of Service (Military Time): 05-25-2021 14:30 <br />The following data was recorded by (Tech <br />Kris Bell <br />1.00 <br />First/Last Name): <br />1.00 <br />Update Site Maintenance and ISD Logs, TAKE COMPLETE <br />Name of person site keys returned to or Did <br />did not use <br />PICTURES and attach to job: <br />Not Use: <br />The status of this task is: CLOSED - COMPLETE <br />Brief Summary of Repairs or Additional <br />replaced damaged fill <br />Details: <br />cap on 87 tank <br />Category: Tanks -Lines <br />Unit#: <br />Component: Fill Bucket <br />Item : PERMIT <br />Failure: Permit Inquiry -Environmental <br />Serial#: <br />Repair: <br />Task#: 7 <br />Labor and Travel <br />Start Date Tech Name <br />5/25/2021 7:30 AM KRISB <br />5/25/20217:45 AM STEVEW <br />Parts and Materials <br />Entry Date Description <br />Qty <br />5/25/2021 Cap, Fill, 4in EVR <br />1.00 <br />5/25/2021 Bucket, Fill, 5 Gal, w/ Drain Valve, EVR <br />1.00 <br />4/02/2021 Drop Tube Tester <br />1.00 <br />4/02/2021 Misc Safety Equipment <br />2.00 <br />4/02/2021 Nitrogen Charge <br />1.00 <br />4/02/2021 Labor Per Bid <br />1.00 <br />5/25/2021 Permit Agency Charge <br />1.00 <br />5/25/2021 Permit Inquiry Fee <br />1.00 <br />Equipment and Fees <br />Entry Date Item Description Qty <br />4/02/2021 QUOTED EST TAX Tax (Estimated) 1.00 <br />5/25/2021 SPECIAL ORDER PARTFPA 4x6 inch Nipple Riser 1.00 <br />Report Date: 5/25/2021 3:50:29 PM PST Page 2 of 3 <br />
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