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SITE INFORMATION AND CORRESPONDENCE FILE 3
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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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 3
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Last modified
6/21/2019 5:29:52 PM
Creation date
6/21/2019 3:23:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 3
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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i <br /> 2575 Country Club Blvd. <br /> Stockton, CA 95204 <br /> NO DISCHARGE OF GROUNDWATER O\C_C-U/RRED AT THIS LOCATION <br /> ✓� D <br /> DURING (MONTH[VEAR) Q 2W&7J�y <br /> I certify under penalty of law that this document and all attachments were prepared under my <br /> direction or supervision in aceordance with a system designed to assure that qualified personnel <br /> properly gather and evaluate the information submitted. Based on my inquiry of the person or <br /> persons who manage the system, or those persons directly responsible for gathering the information, <br /> the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. <br /> I am aware that there are significant penalties for submitting false information, including the <br /> possibility of fine and imprisonment for knowing violations. <br /> CORPORATE FFICER <br /> Denis Brown <br /> PRINT NAME <br /> i <br /> i <br /> i <br />` Project Manager <br /> TITLE <br /> DATE <br /> it <br /> i � <br /> f: <br /> E1� <br />
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