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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0505457
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
6/1/2020 11:59:39 AM
Creation date
6/1/2020 11:57:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0505457
PE
2951
FACILITY_ID
FA0006786
FACILITY_NAME
DART CONTAINER CORP
STREET_NUMBER
1400
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
APN
04904047
CURRENT_STATUS
02
SITE_LOCATION
1400 VICTOR RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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�L PROGRAM FILE ; New Change Edit (PROG3) revised 5!21/93 <br /> ' FACILITY ID'# 7A <br /> FACILITY N <br /> WORD.I31 # s� �f� PRIOR SLEEPS MP 0 <br /> I <br /> F <br /> DAIRY; grade A i _ grade 8 Milk Dispenser r of Containers in Mufti-Head unit , <br /> t: FOOD: Restaurant _ Market C=issary ,�.. - Robi le Food _ Produce Stand Ice Plant <br /> Seating laity . Sq Ft -- Market w/Food Prep: Y <br /> Jemporary fled Facility Special Food Event Vending Machines Number of Vending Units <br /> Food vehicle _', !Jake License aE Registration # Color <br /> HAZARDOUS WASTE." 'Eons Generated/Yr A TIERED PERMIT Facility : CA CE M <br /> W=INO, Not?E/Motet No. of knits Jail/Exempt Institution Housing Abatement <br /> Eaplayee Hwsirnaj'. No. of Eaployeft Appedx Dates of Occupancy to <br /> • a <br /> LItilJi4 W►STE; >sr P Vetric(O Pumper Yard Chemigal Toilets Ko. package Tx Pton! _ <br /> j <br /> MEDICAL WASStlE: , Orionry Care Acute Care Skilled Nursing Ls Generator _ Sm GeneratorGeneratorStorage C2-tO3 Storage (11-50) Storage t }50 7 !_,_ Transfer Sta Ltd Hauler Vex CLinio <br /> -- <br /> I <br /> ° RECREATI011AL HCAL�H: Pool/Spa Number of Pools Out of Service Poet Natural Bathing Place <br /> .,.t 7� <br /> ESITE MITIGATION: Environ Assess , tW/GIP Loc laz Waste Haa Nat PPL <br /> Other Read Agency Site Agency: RiACB DTSC NPL Site RIIIH2O Q Other <br /> JSOLID'WASTZ: Landfitt Transfer Sta RecycIing F Waste Storage Fac Ag Waste/Exempt Site , <br /> SN Veh ale lig. btnater —L79.. Stationary Compactor Site <br /> VECTt7lt CONTRQL• -; �.Pouktry Farm Max Wilber of Birds Kennel <br /> EMfMNCY1NOTIFICATI1* for this FACILITY and/or.PROGRAM DAY ]TIGHT <br /> CONTACT<.1=:; ( ) <br /> C ) - <br /> CANTACTw2 <br /> 4ESIGHATED EtiPiAYEEi;#. l P$OGRAN EL FR # r` Y t QJRWT STATUS <br /> OF UNIYSFx.=E _ EPA lD #: INSPECTION CGDE <br /> l;ILL-I and COMk};IAk* ACM&EDGEIIENT: I, the undersigrwd owner, operator or agent of nam?, acknowledge rirat alt 9itP ctrl/or <br /> pr4iOct sQecific PH5/EriD� hourly charges associated with this facility ar activity will be billed to the <br /> ,.I,.,.: . : party identified as the I <br /> SILLING'PARTY ari'thitw fo I dlS4oerti#y t o prepared this appEioation and that the want to be performed will be done <br /> in accordmfce wlth.al!l i la ICAQUfX CMMTY o cs Cod and/or Standards and State and/or Feral laws. <br /> 7 <br /> APPLICANT'S SIGNAS[IRE : <br /> Title- i�C S._ ate- LOZ g—�7U j <br /> AUTHCRIZATION!T0 RELEASE,INFORMTTON: In addition to the above, when applicable, I, the owner, operator or agent of some, of <br /> the property xoeated'atthe above site address hereby authorize th�l1e� release of any and all results, geotechnieal data and/or r <br /> environmahtal/sitCa"OSSMAAt informAtion t4 BAN JOAQUIN COUNTY Ft4LIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISIN as sport as <br /> it is availa4le;•andexit the same time it is provided to me or my r4resentattve- <br /> Fee Amount: Amount Haid Date of Payment Payfett Type Receipt it Check[ -S Recvd By <br /> s7o 11 <br /> A/h <br /> ACCT UN[T CLK <br /> - - --L_ TI lT"I D p- <br />
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