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ARCHIVED REPORTS XR0003475
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0541989
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ARCHIVED REPORTS XR0003475
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Last modified
6/21/2019 9:37:03 PM
Creation date
6/21/2019 3:37:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003475
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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Tom Pinkos, Executive Officer <br /> October 21,2004 <br /> Page 3 <br /> SPILL NOTIFICATION REPORT(REVISED <br /> "I certify under penalty of law that this document and all attachments were prepared under my direction or <br /> supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the <br /> information submitted Based on my inquiry of the person or persons who manage the system, or those persons <br /> directly responsible for gathering the information, the information submitted is, to the best of my knowledge and <br /> belief, true, accurate, and complete I am aware that there are significant penalties for submitting false information, <br /> including the possibility of fine and imprisonment for knowing violations" <br /> Respectfully submitted, <br /> 4 ,IY"A_--- <br /> Gary S Nuss,P E <br /> General Manager <br /> OMI-Thames Water Stockton, Inc <br /> GSN RKS <br /> Enclosures <br /> cc Bill Marshall, Chief of Storm Water Unit, Central Valley Regional Water Quality Control Board <br /> Ms Janna Herren,Director,California Department of Fish and Game,Region 2,Rancho Cordova <br /> Ms Donna Heran,Director, San Joaquin County Environmental Health Division <br /> Mark Madison,Director of Municipal Utilities Department, City of Stockton <br /> Ava Langston-Kenney,Regulatory Compliance Officer, City of Stockton <br /> • <br />
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