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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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14720
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2900 - Site Mitigation Program
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PR0542085
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/7/2020 3:08:18 PM
Creation date
5/7/2020 3:04:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0542085
PE
2965
FACILITY_ID
FA0010858
FACILITY_NAME
SJC PUBLIC WORKS /UTILITY-FLAG CITY
STREET_NUMBER
14720
STREET_NAME
REPUBLIC
STREET_TYPE
St
City
LODI
Zip
95242
APN
05532009
CURRENT_STATUS
02
SITE_LOCATION
14720 Republic St
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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A <br /> •OFFICE NO: SS FACIeTIES INSPECTION REPT <br /> ' <br /> INSPECTOR: <br /> PCA System Task No: <br /> 5B390115001 SAN JOAQUIN COUNTY DPW <br /> WDS NUMBER NAME OF AGENCY OR PARTY RESPONSIBLE FOR DISCHARGE FLAG CITY(CSA 31) <br /> NAME OF FACILITY <br /> NPDES NUMBER <br /> PO BOX 1810 _ THORNY N RMWY 12 E CORNER <br /> AGENCY STREET <br /> FACILITY STREET <br /> (( ))( )( ) STO KTON CA 9 201 STO KTON CA 9 201 <br /> SCHEYO INSPECT DATE AGENCY CITY AND STATE <br /> FACILITY CITY AND STATE <br /> .i�"'✓a"""'' Gu zrnor� <br /> HENRY HIRATA DIR PUB WKS <br /> AGENCY CONTACT PERSON FACILITY CONTACT PERSON <br /> ��Z,G OYJ Z�4 y6Tf 3o14) <br /> A +468-3066- <br /> CTUAL INSPECTION DATE.. -., :AGENCY PHONE NO. - <br /> '` "i•ACILI'I Y PHONE NO" <br /> INSPFC TION TYPE (Cheek One) — — <br /> (Al) "A"type compliance-Comprehensive inspection in which samples are taken.(EPA Type S) <br /> "B"type compliance--A routine nonsampling inspection.(EPA Type C) <br /> (02) Noncompliance follow-up--Inspection made to verify correction of a previously identified violation. <br /> (03) Enforcement follow-up--Inspection made to verify that conditions of an enforcement action are being met. <br /> (04) Complaint--Inspection made in response to a complaint. <br /> (05) Pre-requirement--Inspection made to gather info,relative to preparing,modifying,or rescinding requirements. <br /> (06) Miscellaneous--Any inspection type not mentioned above. <br /> If this is an EPA inspection not mentioned above,please note type. <br /> (Type) (e.g.-biomonitoring,performance audit,diagnostic,etc.) <br /> Were VIOLATIONS noted during this inspection?(Yes/No/Pending Sample Results) <br /> Was this a Quality.AssuZpnce-Bas€.dJrl$pection?(Y,N) <br /> — Were bioassay samples taken?(N=No. If YES,then S=Static or F=Flowthrough) <br /> ---- — —INSPECTION SUMMARY (REQUIRED) (100 character limit) <br /> f0 �ctil� S�i�r �S��A ttiJvC /iN�Y'i�/GCf�O GAJ/O✓!✓/Q�/M <br /> INSPECTOR'S DATA: <br /> INITIALS ��� SIGNATURES �`- - - <br /> DATE <br /> i <br /> For Internal Use: Reviewed By:(1) (Z) <br /> (3) <br /> Reg.SWIM Coordinator <br /> SWIM Data Entry Daze: Regional Board File Number <br />
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