My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
W
>
WATERLOO
>
4907
>
1900 - Hazardous Materials Program
>
PR0519575
>
COMPLIANCE INFO
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
10/12/2018 6:19:26 PM
Creation date
6/12/2018 8:33:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0519575
PE
1921
FACILITY_ID
FA0009358
FACILITY_NAME
COZAD TRAILER SALES LLC
STREET_NUMBER
4907
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710068
CURRENT_STATUS
01
SITE_LOCATION
4907 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
EJimenez
Supplemental fields
FilePath
\MIGRATIONS\W\WATERLOO\4907\PR0519575\COMPLIANCE INFO .PDF
QuestysFileName
COMPLIANCE INFO
QuestysRecordDate
4/15/2016 5:45:44 PM
QuestysRecordID
3058576
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
34
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
cn <br /> X • p� s r <br /> l'A /�e S•.} X'Ar Ae.r A4 e_ <br /> ip ,*/Ill b� ,2u�`o d��Fwc�.� Q�y.Tiea✓ u�q'.rIEG?P�- <br /> Q.4�,rr. COUNTY OF SAN JOAQUIN <br /> a� OFFICE OF EMERGENCY SERVICES RONALD E.aALDWIN <br /> ROOM 610,COURTHOUSE DIRECTOR OF <br /> 222 EAST WEBER AVENUE Elffv OPERATION <br /> STOCKTON,CALIFORNIA 95202 D <br /> • {�IF3t+`'�' TELEPHONE(209)468-3962 <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 OCT - 6 2000 <br /> HAZARDOUS MATERIALS DISCLOSURE SURVEY <br /> SAN JOFQUIN COUNTY <br /> .,.:"" SERVICES <br /> Please read the information on the reverse side before completing this survey form. A separate survey for each business nam <br /> and/or address in San Joaquin County is required. <br /> Business Name: Cozad Trai 1 er . Sales LLC <br /> Business Owner(s)Name: . Delores Hutcheson Telephone: ( 209 ) 931 -4093 <br /> Business Address: 3206 N . Cherryl and Avenue Stockton 95215 <br /> Mailing Address(if different from above): 4907 Water10o Road Stockton 95215 <br /> Nature of Business: Iowbed trailer manufacturing/service Fire District: Waterloo-Morada <br /> Ql. EXYes ONO Does your business handle a hazardous material in any quantity at any one time in the year? See the <br /> definition of hazardous material on the back of this form. If your answer is"No",go to Question 4. <br /> Q2. LDYes LINO Does your business handle a hazardous material,or a mixture containing a hazardous material,in a <br /> quantity equal to or greater than 55 gallons,500 pounds,or 200 cubic feet at any one time in the year? <br /> If"Yes",how long have you handled these materials at your business? ' 19 7 3 <br /> If "Yes',check any of the following conditions that applies to your business?. <br /> ❑ A. The hazardous materials handled by this business is contained solely in a consumer product packaged for <br /> direct distribution to,and use by,the general public. <br /> ❑ B. This business is a health care facility(doctor,dentist,veterinary,etc.)and uses only medical gases. <br /> ❑ C. This business operates a farm for purposes of cultivating the soil,raising,or harvesting an <br /> agricultural or horticultural commodity. <br /> Q3. ❑Yes K]NO Does your business handle an Acutely Hazardous Material? See definition on reverse side of this form. <br /> Q4. ❑Yes I%]No Is your business within 1,000 feet of the outer boundary of a school(grades K-12)? <br /> I have read the information on this form and understand my requirements under Chapter 6.95 of the California Health and Safety <br /> Code. I understand that if I own a facility or property that is used by tenants,that it is my responsibility to notify the tenants of <br /> the requirements which must be met prior to issuance of a Certificate of Occupancy or beginning of operations. I declare under the <br /> penalty of perjury that the information provided on this disclosure survey is true and accurate to the best of my knowledge. <br /> Owner or Authorized Agent: <br /> g res Hutcheson A Date 08/30/00 <br /> Are <br /> ' Title Owner <br /> Signature (Rev 4/99) <br />
The URL can be used to link to this page
Your browser does not support the video tag.