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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1621
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3000 – Underground Injection Control Program
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PR0515035
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SITE HISTORY
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Last modified
2/11/2019 3:57:10 PM
Creation date
2/11/2019 3:03:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
SITE HISTORY
RECORD_ID
PR0515035
PE
3030
FACILITY_ID
FA0012021
FACILITY_NAME
WESTERN SQUARE INDUSTRIES INC
STREET_NUMBER
1621
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
1621 N BROADWAY AVE
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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f SAN gGAQUIN COUNTY PUBLIC HrALTH SERVICES � i� Report #5255 <br /> ENLZ.R .4MEN #� <br /> TA,L E4_,:LTH DIViS�V St r leiit Printed : 10/22 /99 <br /> f 304 E WE,8VRj,AVE•NUE — 3R,D FLOOR i. <br /> STOCKTON , CA 95402 � <br /> Acca,untinr ° O.f ice : 209 468-3420 <br /> i <br /> f TO : WESTERN SQUARE INDUSTRIES INC <br /> 1623. N BROADWAY AVE Account # 0019074 ! <br /> ' STOCKTON , CA 95205 <br /> a <br /> TTN : WARREN SNIDER .VP OPERATIONS Fac ' lity ID 012021 <br /> 1621 N BROADWAY AVE <br /> { STOCKTON <br /> 1 PLEASE RETURN a COPY of THIS STATENENT with YO LIR PAYENT <br /> Servi11ce Activity <br /> Date Description Ht`s f Employee Amount <br /> Invoice #k 065189 --- Date of. invoice: 10/21/99 <br /> 09/02/99 3030 FIELD CONSULT 1 °. Rt)WE~ 00 <br /> 09/0 /99 3030- FIELD CONSULT 5 .::b R'OWE $390 . <br /> Total f r this invoice : 468.00 <br /> P�aymer`rt DUE [)ATE 1 21 j99 i <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> i <br /> i <br /> For all SERVICE FEES penalties will <br /> Penalties will be added_ on all Permits be addedlat the rate of tot 60 days i <br /> at the rate of 100E of the Base Fee 30 past i0oice date and each 36 days <br /> 1 Jays after the due date. . ' 1. thereafter. { <br /> TOTAL DUE this Billin. Period:' $468. 00 <br /> PAYM PENT <br /> Please make Checks PAYABLE ."t'o'. P +S/EHDECEIVED <br /> NOV 1 <br /> SANI JQAQvrN counm <br /> PUBLIQ HEALTH SERVICES <br /> ILE,VuiR�j��kPl7,Ad,1iF,/i�-TH 4�YISION ' <br />
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