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SITE HISTORY
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 HISTORY
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Entry Properties
Last modified
6/21/2019 11:42:13 AM
Creation date
6/21/2019 10:07:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE HISTORY
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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SJLHD - UNn, GROUND 'TANK CLOSURE%AAANDW`MENT INSPECTION <br /> !� (SHADED Ar. 1 TO BE FILLED 1N FOR THE �ST TANK ONLY) <br /> G OWNER NAME OWNER PHONE <br /> E <br /> N r CONTRACTOR CON. PHONE# ' <br /> E <br /> R S J L H D PERMIT I EPA # FIRE PERMIT I (z(.O <br /> INSPECTOR DATE 114Ai TANK # 39 <br /> R RINSED (Y04 METHOD 1RINSE AMOUR-T-- <br /> I <br /> N RINSATE DISPOSAL SITE <br /> f� S <br /> E MANIFEST Y -OR- . OTHER <br /> V VAPORS PURGED JqN) METHOD ej- AMOUNT USED <br /> A <br /> i P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> O _ <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL EEL FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> '% O TANK CONDITION (GOOD R, HOLES) <br /> P N <br /> I S PIPE MATERIAL STEEL FIBERGLASS, OTHER) I FEET Z� <br /> 'PT <br /> I PIPING CONDITION (GOOD, POOR, OLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> F A 1- W <br /> I N 1 +�Z o <br /> E K -2- <br /> L L <br /> D EXCAVATION SIZE: XX YDS OF SOIL: <br /> I A EPTH SOIL TYPE OBSERVATION SAMPLE t <br /> N M P <br /> S P I <br /> P L P <br /> C N <br /> TG TRENCH DIMENSION X X YDS OF SOIL <br /> I <br /> i 0 H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 A OF HOURS SINCE DEWATERING: <br /> aOTHER SAMPLE: <br /> LABORATORY; SAMPLERS NAME: <br /> i II <br /> CLO ----------F <br /> SURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> ):f(! 2:3 01:3(7/88) <br />
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