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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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WILSON
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2300 - Underground Storage Tank Program
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PR0231300
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
7/27/2023 9:04:09 AM
Creation date
6/20/2023 8:47:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0231300
PE
2361
FACILITY_ID
FA0001858
FACILITY_NAME
MY MINI MART
STREET_NUMBER
1756
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
11721005
CURRENT_STATUS
01
SITE_LOCATION
1756 N WILSON WAY
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Underground Storage Tank 6 <br /> Designated UST Operator Visual Inspection Report <br /> 5. OWNER/OPERATOR DESCRIPTION OF FOLLOW-UP ACTION <br /> Number the follow up actions to correspond to appropriate compliance issues from SOctlon 3. <br /> I <br /> I <br /> a. OWNER /OPERATOR A�FiIVOWLEDGEM - <br /> 1 have reviewed the results of the designated NT OF INaPECTION RESULTS <br /> -- S :::::::: <br /> t�f the action(s) taken or to �� taken to torr <br /> U$T operator inspection report and provided <br /> Name Of UST OWner/ Operator <br /> (print) act any compliance issues discovered, <br /> JST Owner/�Oerator Signature <br /> Date -igned -- --- ---- <br />. INSPECTION HISTORY 8/11/2022_ de, <br /> as each follow-up action of Section from the U0 <br /> previous Designated tJ T ---------_ <br /> Aerator inspection Report been completed appropriately? Yes No NA <br /> ttach decUmentafion veri in.g gperopriatq service to this repo <br /> ___ ❑ ® 0 <br /> RELEASE DETECTION ALARM HISTORY --- - <br /> W a COPY Of the alarin histo._ ra -vrt/io- to this report, � <br /> p p Yes Na NA <br /> he monitoring system powered on and in proper Operating mode? ❑ ! <br /> each alarm since the previous inspection been responded to appropriately? ❑ ® � <br /> ach dccumentatlon ver/fying appropriate service to this report.) <br />'e all containment sumps, that have had an alarm since the previous <br /> griated UST operator inspection report, been responded to by a qualified ❑ ❑ © Q Me <br /> ice technician? - <br /> A#anawf <br />;wets marked "No"must be descn'bed by the designated UST operator in Section 3: <br /> page 2 of 4 <br />
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