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SITE INFORMATION AND CORRESPONDENCE FILE 1
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2575
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2900 - Site Mitigation Program
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PR0541989
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SITE INFORMATION AND CORRESPONDENCE FILE 1
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Last modified
6/21/2019 5:10:28 PM
Creation date
6/21/2019 3:11:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 1
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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U . c't. LVV7 z:)ortyi AOyanceo u e o t n v i roninentaI No. 6 18 3 F'. 1 <br /> BATE RECEIVED <br /> SAN JOAQUIN COUNTY 1( E LOG NUMBER <br /> nD lJ llE�E� V F`D ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, 01 95202-3029 w r� <br /> ULA 'L 4 20G'9 Telephone: (209)468-3420 Pax: (209)4fi4-0138 Web: wwwsjgov.org/ehd VX <br /> ENVIR ,�RT��i�16411 PUBLIC RECORDS RELEASE APPLICATION <br /> PERM LSISArQIY colavita BUSINESSIAGENCY: Advanced GeoBnvironmental, tnc. <br /> ADDRESS: 537 Shaw Road CITY/STATEI27P: Stockton <br /> PHONE(1): 2o9-46r-1oo6 PHONE(2): 209-993-3401 FACSIMILE: 209.467.1115 <br /> TENTATIVE"APPOINTMENT DATE: AsAP Time: <br /> (Please allow to business days from date of application submittal-•Tenradve only-must be odnflrmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$1 5 F E(C H CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT' DATE 12/24/09 <br /> Eleetronle Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHO USE ONLY <br /> s <br /> treetill Street Name CRY ❑Unit 1 <br /> ntry Club Boulevard Stockton <br /> /Unit 2 <br /> 6, nit 3 <br /> y. ❑ 4 <br /> 8 — Unit 5 <br /> 10. <br /> nIta <br /> Specific Date Range of Information Requested: From to <br /> r�/�' ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> L�UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT r�h SOLID WASTE FACILITYNEHICLE <br /> Y{O'THER CLEANUP SITE(NON-LOP) El [R nFOOD FACILITY ASTETIRE <br /> L9 UNDERGROUND TANK(MONRORNOIREMOVAL) ❑DOG KENNEL <br /> R162AR000S WASTE GENERATOR El DAIRY <br /> ❑CHICKEN RANCH El WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOMI. <br /> ❑TATTOOIBObY PIERCING ❑PUMP ERTRUCKICARON SITE$AL TOILETS <br /> MEDICAL WASTE FACILITY ❑OTHER(P El LAND USE APPLICATION SITES <br /> ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-G:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uD to ton addresses In the space above. Select the type(a)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(208)484.0138 or mall to the address Indicated above Addrese <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD flies exist An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly, <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)488-3428. <br /> EMD U9E ONLY <br /> EHD 4949 <br /> 9127/09 <br />
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