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FIELD DOCUMENTS FILE 1
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2705
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3500 - Local Oversight Program
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PR0544595
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FIELD DOCUMENTS FILE 1
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Last modified
6/24/2019 10:22:33 AM
Creation date
6/24/2019 9:25:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0544595
PE
3528
FACILITY_ID
FA0002048
FACILITY_NAME
TESORO (Shell) 68221(WRR 6290)
STREET_NUMBER
2705
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12121008
CURRENT_STATUS
02
SITE_LOCATION
2705 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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REQUEST FOR PRIORITY REVIEW: <br /> TO; SAN JOA Q U17V COUNTY PUBLIC HEAL III SERVICES <br /> ENVIRONMENTAL IJEALTH DIVISION <br /> 445 SAN JOAQUIN ST. <br /> P.O. Box 2609 <br /> Stockton, C4 95201 <br /> FROM. 6= If. <br /> ,(Coinpally name) <br /> RE: 2- 3 2006 2-2.05- el,4_111111, S" 4, <br /> (facility address) <br /> I(We) request that our project be assigned to available San Joaquin County Public Health <br /> Services, Environmental Health Division (PHS-ERD) staff as a priority review. <br /> I(We) understand that the review fee for this priority request is conducted during offm hours <br /> at an overtime rate of time and one-half of$53.00 (1.5 x $53.00). <br /> Furthermore, I(We) understand that the PlIS-EIII) will bill the responsible party(ies) <br /> identified on the "Site Mitigation Acknowledgement/Request for Services Form"for services <br /> rendered. <br /> AUG 15 1991 <br /> FNVIRONMENTAL H[ i <br /> PERMTISERVICEz- <br /> Signature and Title Date <br /> Page 17 <br />
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