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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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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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03!04/20(83 18:58 464017*004 ENVIRONMENTAL R1,4M PAGE 01 <br /> via Vw. limaFA <br /> JOAQUIN COUNTYPUBLIC HEALTH SERVICES � <br /> L I! ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENtM; HIRD TFLOOk ' <br /> MSIR. 0 4 200 STOCKTON CA 95202 <br /> (209)4W3420 <br /> HC LIP 1177 <br /> RECORDS RELEASE APPLICATION <br /> J V <br /> APPuc. � / (� L.� f,5 _sUSINSWAGIENCT -4m. sSpC tA�S <br /> ADORr 3&(V Mid bl So AVE., '5wrg Ca il �f/G—a <br /> t lOI9E[9/b 33 9'� f/1 77 _ r I'AdstNILE 'f f lto)'33 <br /> TENTATIVIV APPOtN MOMbAn _r_ M .1f� 7,X03 MME IZUM Pot. <br /> . (Plo"a of"Y tv:b trwMasa dais horn strte pT xWi;a dne subnmtaq Z <br /> -- DAYSt 3 <br /> CHECK 8070 TO pCPEOfrE RL r S6t1.00 FEE-REQUEST PROCESSED IN�BUSINESS �'� <br /> ` SIGNATt1RE OF APPLiCA DAT1= <br /> FU ADDRUS THVJ$WE 00 STAff USE ONLY <br /> . PRoc,�tAas acr�rrT's sp,ARCN <br /> 7 b1 G i AJ <br /> 7w C <br /> 4w t,v , <br /> ? <br /> 114, AbW~470W, 7Al..07&K d,9' ` 1661 <br /> ENVIRONMENTAL HEALTH DIVISION FILESSH <br /> LMNItGROiJWD'rANK(UST)CI.EMUP Sff6(LDP) C1 HOWINGABATEMENT 0 SWU WAS'T'E FACIIJIT <br /> OTHER ctzmuP wM(Nm"(P) I XOOO FACAM D SOUD waste Veer= <br /> UAG OUNI)TAM OWNTTORI�t M MOVAL) DOG KENNEL O Dwy <br /> . HAZARDWS WAM GRWRATOR 0 CWCKEN RANCH O PKG TREATIOVINT PtJ1NT •• . <br /> Q T1�iEq PEriMrITED FACUTY D MOTELMOTEL C PWAPEK IRXJWARWCWA 10kU73- <br /> G YA11000M PORCING 0 POOLWAX�t+AN1Y USE APPUCATlON$nW <br /> O M9=AL WAS t'@ FACiLM Ta oTHIwR WLEA3'11 SPECIFY MOV10 <br /> 1. List up to ton addresses to the spaae above. Solect the types)of files from the list above by checking <br /> • the appropriate box(es). At least one fila typo MUST be solactod. Fax to 1209,4x3.0.0135 or mafl_to tf3e , <br /> e•. addreas_Int ated-above. <br /> 2 'EHE)will notify the applicant if any ZMD go exist, An flppolntmeAt for inview ain be confirmed <br /> approximately five business days but no later than tart-(10j days aftet receipt of application. Tho files <br /> • • w0l be held for a maximym of five business days for review. Appointments should be scheduled <br /> accordingly, <br /> 3. A file that.is actively boing worked on by EHD stair may not'bo Immediately a"llable for reviow. A new <br /> application relay be submitted when the file is available. <br /> .4. Any Rae not iaWrnad In the same condition as released will bit reorganized by EHD stall at the expense <br /> of,the applicartL Future rile reviews by the same applicfnt may require a$89.00 deposit prior to review. <br /> S. 'TENTATIVE appointdient dates must•be conflrmad with EHO staff.. . <br /> •G. ppplta tions roceiveo atter 3:09 pea w11T be processed the next busfneais day. RUSH <br /> CONFIRMED A ppvtNTmuT DAtE.�� nmr= <br /> DATE CONFIRMED . PHONE FAX INITIALS _ <br /> REVIEWED YES NO REVIEW DATE '" � <br />
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