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UAR/PROP 65
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0523417
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UAR/PROP 65
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Entry Properties
Last modified
7/6/2020 4:43:57 PM
Creation date
11/7/2018 7:01:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
UAR/PROP 65
RECORD_ID
PR0523417
PE
2381
FACILITY_ID
FA0015827
FACILITY_NAME
DUTRA FARMS
STREET_NUMBER
19589
STREET_NAME
MCKINLEY
STREET_TYPE
AVE
City
MANTECA
Zip
95337
CURRENT_STATUS
02
SITE_LOCATION
19589 MCKINLEY AVE
P_LOCATION
04
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\M\MCKINLEY\19589\PR0523417\UAR_PROP 65.PDF
Tags
EHD - Public
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'SAN JOAQUIN COUNTY <br /> j ENVIRONMENTAL MALTH DEPARTMENT 304 East Weber Avenue,36 Floor, Stockton, CA 95202-2708c (OF(209)468-3420-Far(209)464-0138 • Web:www.co.sanjoaquin.ca.us`hF1L E <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE C <br /> California Health & Safety Code, Section 25180.7 <br /> EHD LOG#: 05 -OZ 9 <br /> A. EMERGENCY LEVEL H III <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: D4108 ��,ts �'i� Phone: (ws) <br /> Company: L. h l- A l r <br /> Address: I7W7 LI flit brdiyz sf• ity: S44USade- Zip Code: 9S' Zr <br /> Designated Employee Name: m <br /> Reporting Agency Name: <br /> Address: City: 6. Zip Code: 4 <br /> C. LOCATION AND/DATE OF DISCHARGE A (,, <br /> Location: ��� 'b 9 Mc- ��n�I j 4 vc ,V�r N r`^i / Ci r County <br /> (Best Physical Description) (Circle One) <br /> Date of Discharge: 01JVAgv-A Date Notified: 0 Time: A M P.M. <br /> D. RESPONSIBLE PERSONBUSINESS <br /> Name of Business: DU{"rA F4-rt"S <br /> Contact Person: PeJC. ()AN Phone: (Via 2'7i-_- <br /> 1/6.4 <br /> Physical Address: 16>0 W • S4'11A C t" City: S,AiJ Som. Zip Code: <br /> Mailing Address: 4 City. w Zip Code: d <br /> E. DESCRIPTION <br /> Type of Discharge: SD 7 L <br /> Volume: 0 N VLA0 V-- <br /> Chemicals: <br /> Chemicals: o �- <br /> Circumstances: rn I e65c.e ex Qm� /I i 7'ane <br /> F. ACTION TAKEN: nfi. AL 41=!3 <br /> SITE DISPOSITION: V ►ul�t <br /> EHD 22-02-003 - Notification of Haz Discharge <br /> inannm <br />
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