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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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1900 - Hazardous Materials Program
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PR0520719
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
10/19/2021 2:21:57 PM
Creation date
8/11/2021 10:45:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0520719
PE
1921
FACILITY_ID
FA0011171
FACILITY_NAME
COSTCO WHOLESALE #172
STREET_NUMBER
25501
Direction
S
STREET_NAME
GATEWAY
STREET_TYPE
BLVD
City
TRACY
Zip
95377
APN
20911050
CURRENT_STATUS
01
SITE_LOCATION
25501 S GATEWAY BLVD BLDG C
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
Tags
EHD - Public
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REF#: <br /> INCIDENT INVESTIGATION REPORT FORM <br /> TEAM INFORMATION AND RECOMMENDATIONS <br /> Date and time that team commenced investigation: 5/26/21 @ 1200 pm <br /> Location of team's working&support documents: Costco Tracy Wet Depot 172 <br /> Team Membership(List Team Leader First): <br /> Name Title Company Approval <br /> Efrain Adame AGM Costco Wholesale E.A. <br /> Jimmee Kim Facility MGR Costco Wholesale J.K. <br /> Tom Prokes Service Foreman APCCO T.P. <br /> Christopher Evans Service Tech Trainee APCCO C.E. <br /> Recommendations(see Incident Investigation recommendation tracking sheet): <br /> ID# Description of Recommended Corrective Actions Responsible <br /> Party <br /> N/A <br /> Employees(Or Contractors,if applicable)to Review Report: <br /> 3E contacted. Reference#1535868-less than 1 Ib of ammonia <br /> Submitted to Depot Management by the following team member: <br /> Si Date <br /> Jimmee Kim Facility MGR <br /> Name Title <br /> Recommendations Approved by the Following Depot Management Personnel: <br /> N/A <br /> Name Title Approval <br /> Page 4 of 5 II FORM(7/2018) <br />
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