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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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1876
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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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09/13/2004 11:53 FAX 209 9480 ) .12002/002 <br /> SEP 19 '04 11:19RM C Z- BUD ENGINEERING Y p,1f1 <br /> BATE RECEIVED <br /> EHD LOG NUMBER <br /> SAN JOAQUIN CO" UNT'Y <br /> - ENVIRONMENTAL HEAL-Tff DEPARTMENT <br /> __. 304 E Weber A-ve 34 Floor Stockton, CA 95205 <br /> (209)468-3424 Fax: (209)464-4138 Web; www.c0.san-joaquirx.ca,us/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:JIL BUSINESSIAGENCY r <br /> I� <br /> ADDRESS: <br /> pNONE: BV787 FACSIMILE: 12 499— A7 77 <br /> TENTATIVE*APPOENTMENT DATE: 'rime: <br /> I (Ploase allow 1p business days from date ot.application rubmittal) <br /> �I', CHECK BOX To EXPEDITE REQUEST-493.00 F -REQ T VRQCESS ! BUSINESS DAVE <br /> i <br /> SIGNATURE OF APPLICANTDATE ( Q <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> Slraoc - c <br /> . ❑ Llnit 9 <br /> 3, swat p <br /> r 9. 5 r�65-0 yG ❑ Unit 2 <br /> I 4. 9n881 Ory <br /> ,, mwo+ c1tv ❑ Unit 3 <br /> � c. scene ci <br /> 7. `` CIE* ❑. Unit 4 <br /> + 9, Strout C.. <br /> 7. sQon� �. � Cn ❑ Vnit 6 <br /> I �o. Sueel au <br /> ENVIRONMENTAL HEALTH DEPARTMr;NT FILES <br /> kr UNDERGROUNOTANK(UST)CLEANUP SITE(LOP) R HOUSING ABASEMENT 13,SOLID WASTE FACILITY <br /> O OTHER CLEANUP SITE(MON-LOP) 0 FOOD FACILITY 0 SOLIb WASTE VEHICLE <br /> 0 0)YDERGROUND TANK(MoNITORINGIREh1bVAL) 0 DOG KENNEL O'DAIRY <br /> IC HAZARDOUS WASTE GENERATOR 0 CHICK"RANCH 0,PK6TREATMENT PLANT <br /> M T[ERED PERMrrTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUGK1YARD1CHE&I TOILETS <br /> D TATTOOIBODY PIERCING 0 POOL/SPA C LAND USE APPLICATION SITES I <br /> O MEDICAL WASTE FACILITY El OTHER(PLEASE SPECIFY) I <br /> I. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> �I the appropriate box(es). At least one file type MUST be selected, Fax t4(209)464-0138 or mail to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant if any EHD flies exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> j accordingly. <br /> 3. If A file that is actively being worked on by EHD staff may net be Immediately available for review. A new <br /> application may be submitted when the file is available. <br /> e 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the some applicant may require a$93.00 deposit prior to revlew. <br /> 5. II *TENTATIVE appointment Bates must be confirmed with EHD staff, <br /> 6. Applleations received after 3:40.pm will be procesued the next business day. <br /> CONFIRMED APPOIkTMENT DATE <br /> _ _ <br /> PwA-Ir Fax Note 7671 Gate a 1-57c)1} pi <br /> DATE CONFIRMED Wages, i <br /> REVIEWED YES NO Co,lDep+, NSC From A`► ��Ifl� o �ao <br /> Inn<e-oa-0ne {'f ti�1 nom' r r c°_ d r� <br /> 3fV10R7 Phohe If Pheno it 9 37_8 7 j!�7 <br /> 4 <br /> -0" I Frick 0137—$77 <br /> II 09/13/2004 MON 11:16 [T%/)7X NO 72731 2001 <br />
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