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ARCHIVED REPORTS XR0003472
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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ARCHIVED REPORTS XR0003472
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Entry Properties
Last modified
6/21/2019 9:16:46 PM
Creation date
6/21/2019 3:34:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003472
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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_ a <br /> BILL OF LADING <br /> 3909 Park Road,Suite D <br /> Benicia, CA 94510 <br /> dVIROIJMEIYTAL SERVICES <br /> GROUP (877) 748-3040 <br /> Western Region <br /> DELIVERY DATE <br /> .HIPPER/CUSTOMER POINT OF CONTACT <br /> DDRESS PHONE#.1 <br /> 7t_1 -n p It <br /> r 3 r' ,.} z .�r• <br /> 11Y STATE ZIP <br /> ARRIER/TRANSPORTER PHONE# <br /> ONSIGNEE/FACIUTY POINT OF'FMMARD. INC. <br /> ADDRESS PHONE# <br /> 1TY STATE ZIP <br /> "u%Y!iet.a E""A 911113 <br /> 3 <br /> pecral Handling Instruction and Additional Information <br /> 0 FWMIX4a901.1-1.t1411``��MUS iufAHITY MdltfJD ;101 ANDD ?KA-,^11!081' - F1 'IPL, y2w� R ar3�nc`,`F06 VTVI" .w ':"ani nr� Y' <br /> i '' S' m <br /> N,'M4 (6W 947¢^7�}131 11`75) 575-2777 C�R NF1 tt� lSY i[k �. a3Gh�i <br /> Ilacards Provided YES NO Emergency Phone#(677) 748-3W <br /> NIPPER'S CERTIFICATION i hereby declared that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, <br /> larked,and labeled,and are in all respects in proper condition for transport by highway vessel and rad according to applicable mteutational and national government regulations <br /> SHIPPER)PRINT OR TYPE NAME', - C SIGNATURE ' . .` ,r-` skONTH DAY YEAR <br /> CARRIER/TRANSPORTER)PRINT OR TYPE NAME SIGNATURE Uc"TH DAY <br /> X <br /> CONSIGNEE/FACRHY)PRINT OR TYPE NAME SIGNATURE - uoNtrr OAY YEAR <br /> ( x <br /> orm#PSC-tot-RV 6/04 fi <br /> SHIPPER <br />
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