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SITE INFORMATION AND CORRESPONDENCE_FILE 1
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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2705
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3500 - Local Oversight Program
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PR0544595
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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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:1 a all Vv•Lt l ll lJil"411J, Lill � ll!) I.,.�, v- •J., l.i•JV V1 <br /> i 11 P,i'"��'`2,681 4'7AM >_ <br /> i.. \; _'als:_ To 191685S1t361� Y.1 <br /> (209)4$8.3420 <br /> b�Oj- ".LL001 PUBLIC RECORDS RELEASE APPLICAtION <br /> •��I�'.saA IIYi�.�ss A ���� • 1 <br /> EI r�W ' t lRMWAIRZO BUSINESSWIEMCY C-It . a.At a S (N C. <br /> ss�'���� 'PR.asi�-T Pte_pR. � 5v�'�E 4o iZA�►t•� �xioa.►�A�C/,�`�'�O <br /> PHONE=Cjl—, Jam&S (,BOD FACSIMILE L9t+co) <br /> TENTATIVE*APPOINTMENT CATS L3 L• ZS O{ TIME _ � P M •' <br /> }� (PIC-0 9IVQ 710/110(�bU%1MSs daysmb vm date of appliCadon <br /> submkWll) <br /> CNECK BOX TO EXPEDITE REQUEST•;liT FEE—REtxU>;ST Paoc ks !N 3 BUSINESS DAYS -S wok s.,f�l�� orAK <br /> SIGNATURE Of APPLICANT DATE `7 2-C>' <br /> FILE ADOMSS THIS=)E OW.STAFP USX ONLY <br /> PRQGRAM ELZMNTB SEARCH <br /> "7 2FiTOLY CLA)z Q roc r.X= 3Sa rrw <br /> JlZlfff tRw S t�.•ro�.1 <br /> S V-w•F--.n A51-7c1 rte:j <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNPOAGROUND YANK(U3T1 CLEANUP SITE(IAP) D HOUSING ABATEMENT a SOL16 WAIiTE F�1eMa1 Y <br /> OTHER CLEANUP SITE(NON•LOP) 13 FOOD FACILITY O two VYASTE VEHICLE <br /> O UNDERGROUND TANK(MOMn ORWGMEMOVAL) O DOQ KONNEL O DAIRY <br /> C1 hA3'AADOV3 WASTE GgHERATOR O CHICKEN RAMCH V PXG TREATMENT PLANT <br /> O TIERED PEPAUTY90 FACILITY O MOTEOHOTIM CI PUMF!XRT6t(iCWNiQICNEM 7Da.ETs <br /> O TATrOWBODY PRIMING O POOLWA mJ LAND 989 o1PPt.ICATION Elm <br /> O MLOICAL WAST6.FACILITY O PUBLIC WATERSYSTEM O OTHER OL111ASL 3ftCIFYAOOVq <br /> :1. list up,4b ten addresses In the space above. Select the type(S)of tiles fmmrm'ths 0#* above by checking <br /> the appropriate box(es): At least one file type MUST be selected. Fax Lo f2A9l 4644138 or mail to the <br /> address tnd(cated above <br /> 2. F.HD y1ill notify the applicant If any EHO files exist. An appointment for review wlfi die confirmed <br /> approximately five busidess days but no later than ten.(10)days after receipt of appficatlomi" The flies <br /> will be held for a maximum of five business days for review. Appointments should be scheduted <br /> accordingly. <br /> 3. A filo that 13 actively botltg worked on by END staff may not bo immediately available for relriaw. A new <br /> application May be submitted when the f1le.ms availabis. <br /> �4. Any file not returned In the same condition as reloa;ea will be roorganIzOd Ir.Y EHO.staff at ft expense. <br /> of the applicant. Future file reviews by the some appitcant may require a$".46 deposit prior to review. <br /> 5• 11TENTATIVE appointment dates must be confirmed with EHO staff. <br /> 6. Applications received atter 3:00 pm will be processed the next business day. <br /> i <br /> : O IRM ED APPOINTMENT DATE TIME <br /> (DATE CONFIRMED PHONE FAX m r{Ai_S <br /> �IEVIEVMD YES NO REviEW DATE <br /> l ""no <br /> TOTAL P.62 <br /> a <br />
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