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BILLING
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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T
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12 (STATE ROUTE 12)
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8932
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1900 - Hazardous Materials Program
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PR0519521
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BILLING
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Entry Properties
Last modified
11/19/2024 3:47:07 PM
Creation date
6/11/2018 6:02:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
RECORD_ID
PR0519521
PE
1921
FACILITY_ID
FA0009291
FACILITY_NAME
TEDS WELDING & REPAIR
STREET_NUMBER
8932
Direction
E
STREET_NAME
STATE ROUTE 12
STREET_TYPE
(none)
City
VICTOR
Zip
95253
APN
05138005
CURRENT_STATUS
Active, billable
SITE_LOCATION
8932 E HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\8932\PR0519521\BILLING .PDF
QuestysFileName
BILLING
QuestysRecordDate
8/31/2016 4:09:25 PM
QuestysRecordID
3028960
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACILITY INFORMATION <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION, PAGE 2 <br /> LOCALLY COLLECTED INFORMATION <br /> (03/22/2011 - 10:46:32 AM) <br /> TYPE OF38 A D SITE NETWORK I. <br /> ORGANIZATION ®Single Owner [I Partnership <br /> ❑Corporation ❑Public Agency NO <br /> ASSESSOR PARCEL NUMBER 140 NEAREST CROSS STREET 141 <br /> 051-060-30 BRUELLA <br /> PROPERTY OWNER NAME(If different from Business Owner) 142 PHONE NO. 143 <br /> BILL BRAUN 209-603-8979 <br /> PROPERTY OWNER STREET ADDRESS 144 1 PROPERTY OWNER CITY 145 STATE 146 ZIP CODE 147 <br /> 8832 E.HWY 12 VICTOR CA 95253 <br /> FIRE DISTRICT NAME 1 I FIRE DEPT NO. 14 FACILITY LOCK BOX 15 IF YES,WHERE IS IT LOCATED? 151 <br /> MOKELUMNE FD 13 NO <br /> NATURE OF BUSINESS 152 <br /> WELDING REPAIR SHOP <br /> WASTE GENERATOR 153 1 IF YES,ENTER EPA NUMBER 154 <br /> YES 3241781 <br /> TRADE SECRET INFORMATION 155 SPILL PREVENTION AND COUNTERMEASURES PLAN PREPARED FOR FACILITY? 156 <br /> NO YES <br /> TRAINING PROGRAM INFORMATION 157 <br /> Does your business have an employee training program that includes initial training and annual refreshers? NO <br /> Does your business maintain written training records that show the training subject,date(s)of training, NO <br /> names and signatures of employees trained,and names of instructor(s)? <br /> BILLING ADDRESS If different from Mailing Address,otherwise leave blank <br /> BUSINESS BILLING ADDRESS 158 <br /> P.O.BOX 726 <br /> BUSINESS BILLING CITY 159 STATE 160 ZIP CODE 161 <br /> VICTOR CA 95253 <br /> This area intentionally left blank <br />
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