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SITE INFORMATION AND CORRESPONDENCE FILE 3
EnvironmentalHealth
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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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10969 Trade Cam Drive, Suite 107 <br /> I e CONESTOGA= ROVERS Rancho Cordova, California 95670 <br /> & ASSOCIATES Telephone: (916) 889-8900 Fax : (916) 889-8999 <br /> www. CFIAworld.com <br /> TRANSMITTAL <br /> DATE: May 9, 2012 REFERENCE No.: 240783 <br /> Former Shell Service Station, <br /> 2575 Country Club Boulevard, <br /> PROJECT NAME: Stockton, CA <br /> TO: Ms. Lisa Medina <br /> San Joaquin County Environmental Health � �� � „ ., <br /> Department t; tV ¢,x;. ;t11.: <br /> 1868 East Hazelton Avenue <br /> Stockton, California 95205 MAY 1 <br /> ENVIRONMENTAL HEAD-H <br /> PERMIT/SERVICES <br /> Please find enclosed: ❑ Draft ❑ Final <br /> ® Originals ❑ Other <br /> ❑ Prints <br /> Sent via: ® Mail ❑ Same Day Courier <br /> ❑ Overnight Courier ❑ Other <br /> QUANTITY DESCRIPTION <br /> 1 Permit Application with required information (Driller's Authorization and site plan) <br /> 1 Master File Record Form <br /> 1 Site Plan <br /> 1 Permit fee in the amount of $125.00. <br /> ❑ As Requested ® For Review and Comment <br /> ❑ For Your Use ❑ <br /> El <br /> COMMENTS: <br /> Please contact Larry Silva at 916-919-8914 for any questions or comments regarding this application. <br /> Copy to: Filing <br /> Completed by: Larry Silva Signed: <br /> [Please Print] <br /> Filing: Correspondence File <br />
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