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SU0004625 SSCRPT
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SU0004625 SSCRPT
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Last modified
5/7/2020 11:30:59 AM
Creation date
9/9/2019 10:45:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0004625
PE
2622
FACILITY_NAME
PA-0400476
STREET_NUMBER
16848
Direction
N
STREET_NAME
TULLY
STREET_TYPE
RD
City
LODI
APN
05303010
ENTERED_DATE
9/2/2004 12:00:00 AM
SITE_LOCATION
16848 N TULLY RD
RECEIVED_DATE
8/30/2004 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
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FilePath
\MIGRATIONS\T\TULLY\16848\PA-0400476\SU0004625\SSC RPT.PDF
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EHD - Public
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09/13/3004 12:49 2093345374 WGP SOUTHWEST NOCAL PAGE 03 <br /> '%DWI ... <br /> Environmental Site Assessment <br /> Key Site Manager Questionnaire <br /> To the best of your knowledge, do any of the following documents or situations exist, or have you been <br /> made aware of them in the past: <br /> Yes No__ZOnkwn (A)Environmental Assessments-Phase I,Phase II, Asbestos, etc. <br /> —Yes Nonkwn (B)Environmental Permits. <br /> —Yes—No .- nkwn (C)Underground storage tank applications,permits, or registrations. <br /> —Yes—No A-�6nkwn (D) Community Right-to-Know Plan, Material Safety Data Sheets, <br /> Environmental Safety Plans, Environmental Operations and <br /> Maintenance Programs. <br /> —Yes 1Vo Unkwn (1)Is the Property or any Adjoining Property used for an industrial use? <br /> _Yes No -(Jnkwn (2) To the best of your knowledge, has the Property or Adjoining <br /> Property been used for an industrial use in the past? <br /> _Yes , 4o_Unkwn (3) Is the Property or any Adjoining Property, either currently or in the <br /> past, been used as a gasoline station, motor repair facility, commercial <br /> printing facility, dry-cleaners, photo developing laboratory, junkyard or <br /> landfill, or as a waste treatment, storage, disposal, processing, or <br /> recycling facility? <br /> _Yes o_Unkwn (4)Are there currently, or to the best of your knowledge have there been <br /> previously, any automotive or industrial batteries in significant <br /> quantities, or pesticides, paints, or other chemicals in individual <br /> containers of greater than five gallons in volume or fifty gallons in the <br /> aggregate, stored on or used at the Property or within the facility_ <br /> _Yes tAo_Unkwn (5) Are there currently, or to the best of your knowledge have there been <br /> previously, any industrial drums (typically 55 gallon) or sacks of <br /> chemicals located on the Property or at:the facility? <br /> _Yes No vUnkwn (6)Has Fill Dirt been brought onto the Properly which originated from a <br /> // contaminated site or which is of an unknown origin? <br /> _Yes No�1 nkwn (7)Are there currently, or to the best of your knowledge have there been <br /> previously, any Pits, Ponds, Surface Impoundments or Lagoons located <br /> on the Property in connection with waste treatment or waste disposal? <br /> KEY SITE MANAGER QUESTIONNAIRE WGR Southwest,Inc. <br /> Site address Pagc l of 4 <br />
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