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COMPLIANCE INFO_1986-1995
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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2575
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2300 - Underground Storage Tank Program
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PR0231070
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COMPLIANCE INFO_1986-1995
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Last modified
1/30/2023 1:21:59 PM
Creation date
6/3/2020 9:43:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1986-1995
RECORD_ID
PR0231070
PE
2351
FACILITY_ID
FA0006439
FACILITY_NAME
COUNTRY CLUB MOBIL CIRCLE K
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231070_2575 COUNTRY CLUB_1986-1995.tif
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EHD - Public
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12. What is the depth to <br />1 _ r^. <br />13. Are there any water wells on this parcel or adjacent properties? YES NO [ ] <br />oN-SITS <br />NONE oN t�DJRCeVT <br />P/cc.Fa1271e-5. <br />14. 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 be 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 />Day Phone <br />Page 6 <br />70) <br />oN-SITS <br />NONE oN t�DJRCeVT <br />P/cc.Fa1271e-5. <br />14. 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 be 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 />Day Phone <br />Page 6 <br />
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