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ARCHIVED REPORTS_PUMP RPTS 2013
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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AVENUE 13
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28777
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4200 – Liquid Waste Program
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PR0536480
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ARCHIVED REPORTS_PUMP RPTS 2013
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Entry Properties
Last modified
12/3/2020 4:31:23 PM
Creation date
8/5/2020 10:00:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
File Section
ARCHIVED REPORTS
FileName_PostFix
PUMP RPTS 2013
RECORD_ID
PR0536480
PE
4246
FACILITY_ID
FA0020673
FACILITY_NAME
KALIFORNIA GOLD AG SERVICES
STREET_NUMBER
28777
STREET_NAME
AVENUE 13
City
MADERA
Zip
93638
CURRENT_STATUS
02
SITE_LOCATION
28777 AVENUE 13
P_LOCATION
98
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\4200 - Liquid Waste\A\AVENUE 13\28777\PR0536480\PUMP RPTS 2013.PDF
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EHD - Public
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RECEIVED . . lr <br /> SAN JOMJUiN COUNTY o <br /> t +-_ ENVIRONMENTAL HEALTH DEPARTMENT Return this form by the <br /> u <br /> -- 600 East Main Street, Stockton,CA 932x2-3929 NOV ® 2013 '12 of each month n) <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:wvA r.sjgav,orglend m <br /> —� EPTAGE LEAN 'S REPORT ENVIRONMENTAL HEALTH <br /> PERMIPSERVICES <br /> Company Name: �- /�'� Report for th of: Year m <br /> z67 <br /> `n <br /> Company Address. Signature: W <br /> ` stee.qaSes3 cry za cxd& <br /> Alt information submitted must be complete, accurate, and la ible <br /> (R) RESICENTLkL 3 <br /> DATE NAME OF BUSil1ESS OR ADDRESS WHERE WORK WAS DONE GALLONS NAVE OF TREATMENT <br /> o PUMPED PROPERTY OPIPtER <br /> P Lib1PE0 (G) GREASE TRAP FACILITY D <br /> w PLEASE IUCLUDE STREET 8, DIRECTION, STREET NAVE AND CITY C CHFiDGAL r <br /> H <br /> CD <br /> O <br /> Z <br /> O <br /> 4— <br /> CAYD <br /> G) <br /> 0 <br /> z _ r <br /> � f <br /> ti <br /> Wcty <br /> In <br /> cgy 01 <br /> lD <br /> CZY <br /> kL <br /> Cdy Q <br /> W <br /> Orty <br /> cty <br /> Cdy <br /> 0 <br /> N <br /> IU <br /> Q <br /> lD <br /> C (3r) <br /> CD <br /> CkyW <br /> Ofty co <br /> city <br /> V-� <br /> END 42-t34 S EP TA GE CLEkNERS R EPO RT <br /> 1 Q'4,T]7 <br />
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