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UAR/PROP 65_PRE 2019
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2300 - Underground Storage Tank Program
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PR0503357
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UAR/PROP 65_PRE 2019
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Entry Properties
Last modified
1/19/2022 3:20:01 PM
Creation date
10/12/2018 3:08:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
UAR/PROP 65
FileName_PostFix
PRE 2019
RECORD_ID
PR0503357
PE
2381
FACILITY_ID
FA0003760
FACILITY_NAME
SUNWEST LIQUORS
STREET_NUMBER
2449
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
02741005
CURRENT_STATUS
02
SITE_LOCATION
2449 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
TMorelli
Tags
EHD - Public
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o ,U30 <br /> UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (LEAK)/CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES ^'FOR LOCAL'AGENCY.USE ONLY <br /> REPORT BEEN FILED? E] fTR <br /> ❑ <br /> YES <br /> NO YES NO 1HEREBY CEFYTHAT I HAVE DISTRIBUTED THIS INFORMATION ACCORDING TO THE <br /> CASE <br /> DISTRI E BACK PAGE OF THIS FORM <br /> REPoRT DATE <br /> M ZSIGNED DATE <br /> NAME OF INDIVIDUAL FILING REPORT. PHONE SIGN <br /> �IP/G -77—`v4,0 (LO'T) x/68-0333 <br /> w REPRESENTING ❑ OWNEWOPERATOR ❑ REGIONALBOARD I COMPANY OR AGENCY NAME PAS- <br /> S LOCALAGENCY ❑ OTHER �'�= G++. PA - A/k> <br /> ADDRESS <br /> Ave- 5r <br /> SIRE" CT' STATE ZV <br /> j NAME J CONTACTPERSON PHONE <br /> T� QS/ E:] UNKNOWN ��7 /'9 p (ZiD'� <br /> yu ADDRESS <br /> ZNN"1 u'• �-��.i+o G9 � Lo.�� ci}- g5 z 5�Z <br /> STiEEf CRr STATE <br /> FACILITY NAME(IF APPLICABLE) OPERATOR PHONE <br /> SwZ � t ' r (znj 3s3-�.3�o � <br /> < ADDRESS <br /> w srREEr cm couxrr IP <br /> m CROSS STREET <br /> 1-,7woe— �OC,rA9�+�T'r� /Qtv1 <br /> p LOCALAGENCY AGENCY NAME CONTACT PERSON PHONE <br /> z <br /> w� sSCo A;g ( ) <br /> w M REGIONAL BOARD PHONE <br /> y (1) NAME QUANTITY LOST(GALLONS) <br /> a O <br /> 6A 5; <br /> NKNOWN <br /> w <br /> �i <br />
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