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I <br /> HAZARDOUS WASTE GENERATOR <br /> FILE COVER SHEET <br /> FACILITY ID#: FA0003626 P/E: 2220 DATE: 04/22/2008 <br /> PROGRAM RECORD#: PR0527831 P/E: DATE: <br /> XF,C,, Lo f � P'v-5 P/E: DATE: <br /> ADDRESS: 3212 N CALIFORNIA ST CITY: STOCKTON <br /> FACILITY NAME (DBA): OAK PARK GAS & CONVENIENCE STORE <br /> FACILITY PHONE: (209) 941-2694 FACILITY FAX: <br /> FACILITY CONTACT: KHA O VO PHONE: <br /> OWNER NAME: VO, KHA O CITY: STOCKTON <br /> OWNER ADDRESS: 2207 N YOSEMITE ST PHONE: 9) 948-2229 <br /> Water Service: Large PWS ❑ Small PWS ❑ Domestic Well <br /> Sewer Service: Public Sewer ❑ OnSite WWTX Q Onsite Septic System <br /> Stormwater: Street Drains ❑ Street Ditches ❑ OnSite Ponds ❑ Other <br /> EPA ID#: � <br /> Lj <br /> EH 00 18 rev 05/2007 <br /> rpt#: HWCS New Owner: Create a New Cover Sheet/Change Label of File <br />