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ARCHIVED REPORTS XR0003533
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 XR0003533
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Entry Properties
Last modified
6/21/2019 8:29:56 PM
Creation date
6/21/2019 3:56:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003533
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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SEP 1 ' 95 11 02 FROM ERICKSON PAGE 009 <br /> ]roe of Caldvrn,o—fn_,0Memd Prate+eon Ager-cT <br /> F. apo•e.,rd Oats". 2050.-0039([-,�.en 9-3044) See Insfrrvdidns on bock of page b. peparriire of Taa<ie Sebsea ccs Ga,wr. <br /> Pleur prow ar type Fw.n des+t2riee far yr an el,Ys(12-PAA)r1'Cie'y^+K <br /> 67 <br /> 5acrawrere•CoCbinea <br /> I Gereeratar's US VA ID No Manifest Dacvmew No 2 Page ? Infonnwative,n the rlwded arcus <br /> UNIFORM HAZARDOUS +c not by Federal so—, <br /> WASTE MANIFEST C R191813 4 9 4 's 4 2 2 1 of I <br /> 3 Geo. amts Name and Ma&V AddressTELL OIL COMPANY A stWC MCKlif se�aarmerit lHvndsbr'Ty. ��� �rw <br /> HAZRRDOUS WASTE DEPT. <br /> O. BO � & Side Gerrerenor's+IDP. * Ir, <br /> Generctor'x mom (7 ) ... T T '� ,v�> <br /> 5 Transpote <br /> . r 7 Company ftorrre 6 US EPA 10 Nirimber C. slateTeoeaPater's to <br /> � � • D T e r .`''d�� <br /> 7 Transporter 2 Company Name $ US EPA ID Number E Stalk Tearaporleg's <br /> L3 � F Trart>peeErrs Pleorr¢ r.;�-w:Ss. <br /> Q 9,.Des+gnaNd fec{iry Norco and SrtAddeu 10 15 EPA ID Numbr <br /> ERICcSOr, I>C_ � Yyr:� a�3Dnr:1;Y.w5�w,.•,i,>?a`ks"I� <br /> CD a 2 <br /> CVU- 2s5 PARR BLVD. C � D0094563 7 <br /> LO <br /> V 12 CoRarnen 13 Told IA Unor ;,` <br /> Z 1 T vs DOT oesr iphwi(rnck,dFeg Proper 9-pp"laarrre f.-M Clan and 10 Nu+aber) Na T vvt/vd 'iv N a ��`>•��", <br /> Q a w t J—Rate-.,r rt.ti <br /> 07 G 0 9 1 T P <br /> 0,8101010 Pcc <br /> m N z ,•^ 3x L St <br /> b <br /> E <br /> A nw y <br /> Tcc <br /> it <br /> uj _a <br /> Z d t xr <br /> � G <br /> W _ <br /> � aN :i��•�:• r`�ar�".�i�t:` � ,w•a".,Nr " �..,,...,r �• � 33Y`�y„"x� <br /> �t 2.� 'a Y� •r+ ++J4,li �,!"`` _ "' > �kur^� 3:7re��ryu> � a r„�, ..,+1�r�K. r�SiCe4 <br /> � M.�r � �`'�.,.� r,,.� M ey., s�_..-'• .. '..� �r�^yy,� x .Y.. ^i"'�a`caNS,�u, !�+err <br /> 0 15 Speoal Ha+drog instTvclfan and Additsorwl 1rtFo*rrtatbn FACILITY: } <br /> C AVOID CONTACT WITH SKIM/EYES SERVICE STATION I <br /> 24 HOUR EMERGENCY PHONE NUMBER (800) 424-9300 2575 COUNTRY CLUB <br /> = STOCKTON CA. 95204 <br /> r <br /> T& 00MATOWS CERMICATIOW I heby dederee the!IM CM aters wruaa <br /> Of rhe cagne are hilly and accurately desenbed obare by proper Shopping nae"soil are cktsnifed <br /> re <br /> Q packed ,narked,and 1-1 A d and ere M ail re,pacts+n proper cond'evair for numwaet by highway occ—iwg to oppfreoble federal,'MCI a and mterriptiomi lar, <br /> V <br /> j IEE am a loiye 4varsny gen-rdor.I car* *at i have o program m dose to reduce the vaiume and Tomwity of waste Qwwmvlsd to rhe degree I have desrrnned to he <br /> owrwwwcalFj procticoble and that 1 ha t sslestud Mrs prockoble m dwW of woom,&nr garage•or deposal curra,tfy avewlable to me riweh minimaos the prewar and future <br /> ythreat to human heahh and The emnronrnws OK d I em a cmdl cirmwi y generawr I have mods a goad faith effon to iMrwereize my +•sue yaneranan aid select the bat <br /> was*mono emeet nw+hod tot,c available to me end Thar I can afford <br /> O Prwded/Typed Nome ON BEHALF OF ""a"h Year <br /> � ]S <br /> N o O5- <br /> Y 17 7 rTer 1 Acknowte of Rees+ of <br /> Z Marek Day Year <br /> wPri.,d a Sg^aRtrc <br /> aC s w t -tQ C/C v <br /> 1iJ <br /> O 1$ T rix 2 Aciena-kic of Rerrpt of Makrk <br /> R Priimed/Typed Name Signature h{oreth Oat Year I <br /> rL <br /> 0 e <br /> 19 De -hepar r lndremean Space <br /> Q F <br /> V A <br /> Z C <br /> I <br /> Lrn 9 <br /> t 20 foci r Own a C—Mfic aF of h M <br /> ordaus ma!*opals covered by flys manifest cx <br /> Day Year <br /> T Prrrecd/Typed Nana SrgTeoniro Monlh <br /> 2047$243505+3982 BYRAN DO NOT WRITE BELOW THIS LINE. <br /> Whtiai TSDR SBNOS ?HIS COPY TO DTSC WITHIN 30 DAYS <br /> DT5C 8o22A (12/91) to P O Box 3000 Sacramcnro CA 95812 <br /> EPA 8700-21 <br /> ** TOTAL PAGE 009 ** <br />
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