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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0544508
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/31/2019 2:12:41 PM
Creation date
5/31/2019 1:58:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544508
PE
3528
FACILITY_ID
FA0004718
FACILITY_NAME
CAINS ELECTRIC WORKS
STREET_NUMBER
230
Direction
N
STREET_NAME
CHURCH
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
230 N CHURCH ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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`I <br /> t I <br /> UST CLAIM APPLICATION <br /> i <br /> INSTRUCTIONS FOR PAGE EIGHT <br /> Ix. PRIORITY CLASS DESIGNATION (Continued) <br /> t <br /> Class C-Other Business- If claiming Priority Class C, Other Business, check this box. ALL of the following <br /> I areas must be completed. Refer to Program Information, Priority CI la�lsses, for the criteria that must be met to <br /> claim this class. <br /> I' <br /> A. Identify the claimant's business name. <br /> B. Specify the claimant's business (i.e., gas station, real estate).;; <br /> i <br /> C. List the dates of when the claimant's business operations began and, if no longer in operation, the date <br /> the business ceased operations. <br /> D. List the address where the principal business office is located. + <br /> E. Check the appropriate boxes in response to the four questions. ; <br /> F. Check the appropriate box to indicate the claimant's type of ownership. <br /> G. List the name, location and relationship of all affiliated companies or other income.producing units <br /> (i.e., parent company subsidiary, franchise, branch). <br /> H. Specify the total number of full-time and part-time employe Is, including all affiliates. i <br /> i <br /> Class C- Local Governmental Entities and Nonprofit Organizations 1f claiming Priority Class C as a local <br /> governmental entity or a nonprofit organization, check this box. Alli of the following must be completed. Refer <br /> to Program Information, Priority Classes, for the criteria that must be!met to claim this class. <br /> A. Check the appropriate box to identify the claimant's status. <br /> I <br /> B. Specify the total number of full-time and part-time employees. <br /> Class D-All Other Tank Owners and/or Operators- If claiming Priority Class D, check this box. No further <br /> Priority Class information is required. } <br /> I <br /> j <br /> i <br /> f <br /> I � <br /> ii I, F <br /> �i <br /> I <br /> } <br />
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