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SITE INFORMATION AND CORRESPONDENCE
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2900 - Site Mitigation Program
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PR0542421
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
6/21/2019 12:25:09 PM
Creation date
6/21/2019 10:07:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0542421
PE
2950
FACILITY_ID
FA0024377
FACILITY_NAME
COUNTRY CLUB BLVD/295950
STREET_NUMBER
1876
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12319101
CURRENT_STATUS
01
SITE_LOCATION
1876 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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BOARD OF TRUSTEES SA%eJOAQUIN LOCAL HEALTH DISiwOC T SERVING <br /> James Culbertson,Pres. City of Lodi <br /> Mary Anna Love,Vice Pres. 1609 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> Patricia E.Vannucci,Sec'y. San Joaquin County <br /> Tommy Joyce Stockton,California 95201 City of Escalon <br /> Eart Pimentel City of Manteca <br /> Virginia Mathews. (209) 466-6781 City of Ripon <br /> Daniel L Flores City of Stockton <br /> John D.Mast,M.D. Jogt Khanna,M.D.,M.P.H.,District Health Officer City of Tracy <br /> San Joaquin County <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE 10--1 -500 <br /> FACILITY $ ,6 C'ovnt"r CIV b +0r- ✓) <br /> OWNER/OPERATOR <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT REPRESENTATIVES GtUr'1 of I.0-fi la <br /> ar� Don a Bran Sr, . S . <br /> 'a <br /> I, hereby, agree to have all violations <br /> per <br /> -File- �Vr' (s) dated `T`17~- `ag pertaining <br /> to the above referenced establishment corrected on or before <br /> I further agree that said violations may be detrimental to the <br /> public health and/or safety and will prevent these violations from <br /> recurring. Failure to comply with this agreement will result in <br /> further legal remedies. <br /> SIGNED BY PROPRIETO <br />
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