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EHD Program Facility Records by Street Name
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BROADWAY
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1621
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3000 – Underground Injection Control Program
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PR0515035
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Entry Properties
Last modified
2/11/2019 4:08:16 PM
Creation date
2/11/2019 3:04:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
WORK PLANS
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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CERTIFICATION <br /> _ <br /> Tac following cextifcation is included 'n this repori as,equircd by-ahe LSEPA Re7cxz 9 C-uidelines <br /> for Closure of Shailow Disposal Wells 199 <br /> I certify under penalty of iaw that this doe-ument and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to zssure that 4ualified personnel <br /> properly gather and evaluate the information submitted. Based on my inquiry of the person or <br /> persons who manage rine system, or those persons directly responsible for gathering the information, <br /> I cerrq� that the ;n{ormation submitted is, to best of my knowledge and belief, true, accurate. and <br /> complete. lam aware thi,t there are significant penalties for submitting false information, including <br /> the possibilily of fine and imprisonment dor knowing violatians- <br /> ,4dvanced GeoFnvironmentai,lu, <br /> Q Ct"pt��i - <br /> 1 <br /> �y is <br /> Caivizl A . Lee <br /> Project Geologist <br /> Califomia Registered Geo <br /> advanced GeoEnviraamenW,Inc <br />
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