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2900 - Site Mitigation Program
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PR0505897
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Last modified
3/31/2020 2:08:04 PM
Creation date
3/31/2020 2:02:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0505897
PE
2950
FACILITY_ID
FA0007071
FACILITY_NAME
SEARS ROEBUCK & COMPANY
STREET_NUMBER
5110
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
02
SITE_LOCATION
5110 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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12. What Is the depth to groundwater? <br /> Uknown <br /> Describe the source of information: <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [ ] NO <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public WeII ft+ <br /> Private Well ft. <br /> Irrigation Well ft. <br /> Monitoring Well Et. <br /> 1 <br /> Other <br /> t4. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ ] NO[ <br /> 15. Indicate the responsible party to he billed for additional PHS-EHD staff time expended beyond 3 hour minimum <br /> permit payment per tank. If the party designated below is different than the permit applicant, e.g. property owner, <br /> the party must acknowledge this responsibility for the billing by signature and date below. <br /> I <br /> .Name Sears Roebuck & Co. <br /> Mailing Address 2100 N. Tustin Orange, CA 92665 <br /> i <br /> Day Phone Number_( 209 ) 477-8111 " (local number) i <br /> w <br /> Signature. l Date.. _ I <br /> _ - <br /> J <br /> Page 6 <br />..-----......... ......................................-.. ...... ... ... .. . ... __............... ............_ _ <br />
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