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ARCHIVED REPORTS XR0005805
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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ARCHIVED REPORTS XR0005805
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Entry Properties
Last modified
6/21/2019 2:42:38 PM
Creation date
6/21/2019 10:21:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005805
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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SJGOV\wng
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EHD - Public
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NON - HAZARDOUS WASTE MANIFEST <br /> 11183 <br /> PROFILE NO <br /> 18C)3-58 3036 <br /> D BAKERSFIELD D YOLO D PHOENIX <br /> f the <br /> NOTE waisteorm to be anifest ITolieu <br /> beoused forToxic <br /> Controls <br /> r NON-HAZARDOUS OUSWASTES only <br /> MR & MRS. MANUEL SANCHEZ <br /> Name <br /> Mailing Address 1633 W. WALNUT <br /> City/ State /Zip STOCKTON, CA <br /> %t 209-464-1291 Contact MARY SANCHEZ <br /> Phone No <br /> � Signature ©ate % <br /> THE GENERATOR CERTIFiFS THAT T E WASTE AS DESCRIBED l5 100% NON-HAZARDOUS <br /> Waste Description MONITORING WELL SAMPLING <br /> 2E 1876 COUNTRY CLUB BLVD , STOCKTON, CA <br /> O Generating Location <br /> U <br /> Handling Instructions <br /> _'136L I x,GLS YDS I ]TONS <br /> Quantity E <br /> n r K E I DRUfJiS � BINS � ]OTHER <br /> CONTAINER TYPE C XITANK TRUCK C _-Ut,P TRUCK <br /> DESIGNATED FACILITY <br /> NAME SEAPORT ENVIRONMENTAL SERVICES ADDRESS 675 SEAPORT BLVD <br /> I CITYfSTATEIZIP <br /> REDWOOD CITY, CA 94063 PHONE ;# 650-364-8154 <br /> TICKET=/La/,_j r-TRACT TRLR- <br /> MP VACUUM TRUCK SERVICE _ s <br /> MP ENVIRONMENTAL. SERVICES, INC 5 c^3ti,re <br /> aI 3400 Manor Street <br /> rn Bakersfield CA 93308 D�'e <br /> Z ' 805 1393-1151 P U DAT Job# <br /> a <br /> Jim <br /> z <br /> TAL SERVICES Disposal Method <br /> Name SEAPORT ENVIRONMENTAL <br /> ❑Landfill Other <br /> Address 675 SEAPORT BLVD <br /> ~ REDWOOD CITY CA 94063 <br /> CltylState/Zip <br /> am <br /> <Phane No 650-364-8154 Time pm <br /> Discrepancy <br /> Signature <br /> Date �—{ � <br />
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