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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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5491
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3500 - Local Oversight Program
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PR0545028
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SITE INFORMATION AND CORRESPONDENCE_FILE 1
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Last modified
12/6/2019 2:59:14 PM
Creation date
12/6/2019 2:48:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 1
RECORD_ID
PR0545028
PE
3528
FACILITY_ID
FA0003919
FACILITY_NAME
VAN DE POL ENTERPRISES
STREET_NUMBER
5491
STREET_NAME
F
STREET_TYPE
ST
City
BANTA
Zip
95304
CURRENT_STATUS
02
SITE_LOCATION
5491 F ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\wng
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EHD - Public
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5uomttal Number 93-`62 Date Received 03/15/93 <br /> Site Code: 1502 <br /> Site Name: MOORE RETROLE*"-K Lead Agency`!"' <br /> Address: 5491 F ST Contact: <br /> City: BANTA Zip: 95304 Rhone: <br /> Billing/responsible Party Information <br /> Billing Name: Bill Info OK? <br /> Address: <br /> City: State: Zip: <br /> Contact: Phone <br /> Property Owner/Operator <br /> Name: Phone: <br /> Address: <br /> City: State: Zip: <br /> Client Information (if different from Owner/Operator) <br /> Nane: Rhone: <br /> Address: <br /> City: State: Zip: <br /> Applicant' s name, date signed, title <br /> Name: Date: <br /> Title: <br /> Consultant Company: AEGIS <br /> Contact Name: Rhone: <br /> Other Contact name or Info: Rhone: <br /> Frogran Element: 3526 Billing Code: Assigned To: ML <br /> 9 <br /> Title of Submittal: QM REPORT <br /> Date of Submittal: 03/09/93 OT Request: N OT Request Date: <br /> Type of Submittal : 9 Quarterly Report/Rost-Remedial Monitoring <br /> Permit Fee paid 0.00 <br /> Check No. /Cash <br /> Date Paid <br /> Permit Fee Raid 0.00 <br /> Check No. /Cash <br /> Date Paid <br /> Staff Review Due: OT Scheduled: OT Completed: <br /> Action Date Action Date Action Date <br /> � Ack/Com Ltr Req Add. Inf Reqstd Srp Due <br /> Ack/Com Ltr Recd Revisi d ' Due <br /> RWQCB Comments 1 Repo , 116 113 R Due <br /> Othr Agency Appr Fil / FRP Due <br /> Add. Info Recvd De ' d Revision Due , <br /> lPermit Type: Special r e th Agency Due <br /> Wrkpin Revw Comp Commen r Project Complt <br />
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