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COMPLIANCE INFO_2023
Environmental Health - Public
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EHD Program Facility Records by Street Name
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GRANT LINE
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3250
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2300 - Underground Storage Tank Program
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PR0518288
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
12/17/2025 2:44:35 PM
Creation date
1/13/2023 9:39:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0518288
PE
2351 - UST FACILITY - 2481 COMPLIANT
FACILITY_ID
FA0013810
FACILITY_NAME
COSTCO WHOLESALE #658
STREET_NUMBER
3250
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95377
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
Site Address
3250 W GRANT LINE RD TRACY 95377
Tags
EHD - Public
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RE. Agent Authorization for Barghausen Consulting Engineers, Inc, <br />Costco Gasoline/Fuel Operations - Regulatory Compliance <br />To Whom It May Concem: <br />Costco Wholesale Corporation {Costco} hereby authorizes Barghausen Consulting Engineers, Inc. <br />(Barghausen) and its designated personnel under its employment to act on behalf of Costco as its <br />Authorized Agent on all matters pertaining to regulatory compliance for the operation of all retail <br />gasoline/fueling facilities owned and operated by Costco in the United States. <br />Costco and Barghausen have entered into a Service Agreement that establishes the terms, conditions, and <br />scope of services of this Agent Authorization granted to Barghausen_ With this Agent Authorization, <br />Barghausen is granted signatory authority on all regulatory compliance materials and documentation. <br />Costco further authorizes that all future regulatory compliance correspondence, notifications, and <br />documentation be forwarded to the following address for further handling. <br />Costco Wholesale <br />c/o Barghausen Consulting Engineers, Inc. <br />18215 72nd Avenue South <br />Kent, WA 98032 <br />Email: Costco@barghausen.com <br />Please call me at (425) 313-8100 with any questions on this matter. <br />Res atfully, / <br />Dwight Larsen <br />Director of Operations <br />NOTARY <br />�zl�1� <br />On this day of April, 2022 before me, the undersigned, a Notary Pyblic in and for the State of <br />Washington, duly commissioned and sworn personally appeared P LC'1 1)i L. 0 r �:Cil known to me <br />to be the duly authorized representative of Costco Wholesale, the corporation that executed the foregoing <br />instrument, and acknowledged said instrument to be the free and votuntary act and deed of said <br />corporation, for the purposes therein mentioned, and on oath stated that he was authorized to execute said <br />Instrument. WITNESS my hand and official seal hereto affixed the day and year in the certificate nhnvP. <br />written. <br />(Signature) /1 <br />(Printed Name) <br />.� NpNf�,� �1►� <br />OTA <br />='u �X <br />�4g0�J <br />• ►1 . r✓$ �1G i- _ <br />�, _ 3 <br />.9 <br />(Seal) +OI WA SNA\\ <br />` <br />1\\1 <br />NOTARY PUBLIC in and for the State of Washington residing at K 1r�4_ <br />My commission expires: C - <br />999 take Drive • Issaquah. WA 98027 ••125/313-81f10 ■ Fox 4251.427-7133 ■ www.cosfco.cam <br />
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