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SITE INFORMATION AND CORRESPONDENCE_FILE 1
EnvironmentalHealth
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SITE INFORMATION AND CORRESPONDENCE_FILE 1
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Last modified
6/24/2019 10:23:11 AM
Creation date
6/24/2019 9:26:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
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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Jan. 15. 2010 6:35PM Aced GeoEnvironmental No, 6294 P, 1 <br /> ((DATE RIE�C�1EIIIVED �_. SAN EHD LOG NUMBER <br /> u � L'_� ENVIRONMENTAL HES <br /> 600 East Main St. Stockton, A <br /> J -N 1 9 2010 Telephone: (209)468-3420 Fax: (209)464-0138 Web:www,sj v.o /e 7 <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> PER 0 ARTHUR DEICKE ADVANCED OEOENVIRONMENTAL, INC <br /> APPLICANT: BUSINESS/AGENCY: <br /> ADDRESS: 837 SHAW ROAD CITY/STATE/ZIP'STOCKTON, CA 95215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209-323-6497 FACSIMILE: 209-467-1118 <br /> 7"i5Nr 7'1VE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> HECK BOX TO EXPEDITE REQUEST-$1 FEE(CA$H OR CHECK ONLY)-REQUEST PROCESSED IN 3 OUSINESS DAYS <br /> SIGNATURE OF APPLICANT t.,• DATE,, <br /> 2010 <br /> Electronic Information: ❑Ust❑Map.—Description: <br /> FILE ADDRESS _ EHD USE ONLY <br /> Street# — Street Name City ❑Unit 1 <br /> . 2705 COUNTRY CLUB BOULEVARD STOCKTON <br /> 2. <br /> 1 N <br /> ❑Unit 2 <br /> 3. <br /> 4. <br /> 4.4 \ <br /> b. <br /> 6' delit4 <br /> 7 _. <br /> 8. <br /> -- ---.—._ .__.... . . ..... -- 0UnkS <br /> 9. <br /> 10. <br /> E units <br /> Specific Date Range of Information Requested: From 1991 to 2009 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> €]UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> {7]UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ❑HAZARDous WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOIL REVIEW: MONDAY-FRIDAY 8:00 AM-5:00pM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type($)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD files exist An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> S. If you need further assistance,please contact Diane Martinez,at(209)468.3426. <br /> END USE ONLY <br /> HD 48.06 8127108 <br />
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