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SU0004625 SSCRPT
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-0400476
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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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09/13/2004 12:49 2093345374 WGR SOUTHWEST NOCAL PAGE 03 <br /> __Yes No__46nkwn (8) Are there currently, or to the best of your knowledge have there been <br /> previously, any Incinerators, Injection Wells, Transfer Stations, Waste <br /> Recycling Operations, Waste Treatment Detoxification, or Land <br /> Disposal Areas located on the Property in connection with waste <br /> treatment or waste disposal? <br /> _Yes_Ao_Unkwn (9) Is there currently, or to the best of your knowledge has there been <br /> previously,any stained soil on the Property? <br /> Yes r<o Unkwn (10) Are there currently, or to the best of your knowledge have there <br /> been previously, any registered or unregistered above or underground <br /> storage tanks located on the Property? <br /> _Yes Xo—Unkwn (11) Are there currently, or to the best of your knowledge have there <br /> been previously, any vent pipes, fill pipes or access ways indicating a fill <br /> pipe, protruding from the ground on the Property or adjacent to any <br /> structure located on the Property? <br /> _Yes Xo_Unkwn (12) Are there currently, or to the best of your knowledge have there <br /> been previously installed, any urea-formaldehyde foam insulation within <br /> the Property? <br /> _Yes__,�Ko_Unkwn (13) Are there currently, or to the best of your knowledge have there <br /> been previously, any flooring, drains, or walls located within the facility <br /> that are stained by svbstances other than water, or are emitting foul <br /> odors? <br /> _Yes J/<o_Unkwn (14) Is the Property served by a private well or non-public water system, <br /> and if so, have contaminants been identified in the well or system that <br /> exceed guidelines applicable to the water system or has the well been <br /> designated as contaminated by any government environmental and or <br /> health agency? <br /> _Yes No Unkwn (15) Does the Owner or Occupant of the Property have any knowledge <br /> of Environmental Liens or government notification relating to past or <br /> current violations of environmental laws with respect to the Property or <br /> any facility located on the Property? <br /> _Yes,No_ennkwn (16) Has the Owner or Occupant of the Property been informed of the <br /> past or current existence of hazardous Substances or Petroleum Products <br /> or environmental violations with respect to the Property or any facility <br /> located on the Property? <br /> —Yes lVo_Unkwn (17) Does the Owner or Occupant of the Property have any knowledge <br /> of any Environmental Site Assessment of the Property or facility that <br /> indicated the presence of Hazardous Substances or Petroleum Products <br /> on, or contamination of, the Property or recommended further <br /> assessment of the Property? <br /> KEY"SITE MANAGER QUESTIONNAIRE WGR Southwest,rne. <br /> Sitz address <br /> Page 2 of 4 <br />
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