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INSTALL_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0548106
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INSTALL_2022
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Entry Properties
Last modified
10/5/2023 4:47:02 PM
Creation date
12/1/2022 9:44:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2022
RECORD_ID
PR0548106
PE
2351
FACILITY_ID
FA0027447
FACILITY_NAME
MOUNTAIN HOUSE CHEVRON
STREET_NUMBER
1124
Direction
N
STREET_NAME
INTERNATIONAL
STREET_TYPE
PKWY
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
1124 N INTERNATIONAL PKWY
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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TANK INSTALLATION CHECKLIST <br /> SITE SKETCH findlab.SP cM04t"kinsairbdonj <br /> Note any variations and/or deviations from <br /> instructions (and attach written authorizations): <br /> ti <br /> , <br /> J <br /> VERIFYING SIGNATURES <br /> CONTRACTOR TANK OWNER/REPRESENTATIVE <br /> I verify that this information is a true record of the installation of the tanks I verify that this information is a true record of the installation of the tanks <br /> listed here . listed here, and that I have received a copy of the Installation Manual <br /> and this Tank Installation Checklist. <br /> Name : ' Cost Name : <br /> Telephones (� (to (12 ,— C( � � Telephone : <br /> Email * <br /> G: f AO Q, tCC CAffi�;, COr-S , ( C) KIEmail : <br /> Address : Address : <br /> Signature : IT <br /> Signature : <br /> Date : 2 Date : p <br /> r <br /> TO INSTALLER : After tank installation, deliver the Installation Manual with the completed Tank Installation Checklist to the tank owner. Retain a copy of G` <br /> each for your records. <br /> TO OWNER : After installation , retain the limited warranty, the Installation Manual and completed Tank Installation Checklist for future reference and to <br /> facilitate any warranty claim . <br /> XERXES® 39 <br /> BY SHAWCOR <br />
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