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ARCHIVED REPORTS XR0006103
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2900 - Site Mitigation Program
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PR0542421
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ARCHIVED REPORTS XR0006103
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Entry Properties
Last modified
6/21/2019 12:38:45 PM
Creation date
6/21/2019 10:30:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006103
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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ICIPAL UTILITIES DEPARTMEN <br /> REGIONAL WSTEWATER CONTROL FACILITIO <br /> ® 25W NAVY DRIVE <br /> STOCKTON, CALIFORNIA 952(6 Groundwater Discharge Attachment <br /> C� OF STOCKTON `209' x9s <br /> "- 76o Part B - Groundwater Description <br /> PURPOSE—The Groundwater Description will be used to evaluate all aspects of the groundwater proposed to be <br /> discharged to the sanitary system <br /> Further instructions on reverse side <br /> B1 Business Activity— Describe the present and past business activity occurring on the premise, as well as present <br /> and past wastewater generating operations <br /> a) Present Activity <br /> Product <br /> Wastewater Generating Operations (s) <br /> b) Past Activity <br /> Product <br /> Wastewater Generating Operations(s) <br /> B2 Description — Describe the known or suspected pollutant source(s) and history of the groundwater contaminants <br /> (Attach sheets as necessary) 0® qa F*/,�- <br /> �'�►e_ 6116)trr1 P amu. <br /> O a Co b O v <br /> M f <br /> B3 Substances Proposed to be Discharged -- Give common and technical names of any materials or chemicals pro- <br /> posed to be discharged to the sewer Briefly descnbe the physical and chemical properties of each substance and <br /> product Give proposed concentrations (Attach sheets as necessary) <br /> NAME / E IP ION CONCENTRATIONS <br /> 1 164 •ham <br /> a <br /> B4 Proposed Quantities—give the average estimated gallons/day as well as peak hourly and peak daily flows in gallons <br /> of the groundwater proposed to be discharged to the sewer <br /> B5 Proposed Discharge Period --- Give the following information - <br /> a) Discharge will occur daily from to <br /> b) Circle the k that the discharge will occur- <br /> S M T W T F S <br /> c) Seasonal — arc e t e month(s) of the year the discharge will occur <br /> J F M A M J J A S 0 N D <br /> d) Years — Indicate the total proposed discharge period <br /> MUD 1089 <br />
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