My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
Y
>
YOSEMITE
>
1460
>
2900 - Site Mitigation Program
>
PR0515018
>
SITE INFORMATION AND CORRESPONDENCE
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/26/2021 2:49:00 PM
Creation date
5/26/2021 1:36:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0515018
PE
2950
FACILITY_ID
FA0012010
FACILITY_NAME
TRADEWAY CHEVROLET/AUTOBODY
STREET_NUMBER
1460
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
1460 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\dsedra
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
12
PDF
View images
View plain text
SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> SITE MITIGATION MASTERFILE RECORD FORM <br /> GENERAL PROGRAM FILE: N,,eew/w t Change Edit (PROG4) revised 5/23/94 <br /> FACILITY ID # I U v I FACILITY "TAME _IA"Ce—vx" 'r C:1,•cJY( //e'+ <br /> RECORD ID # O PRIOR DIST # PRIOR SWEEPS # <br /> JJJ ILA 6 6 E . IC—C--4c , r"A K <br /> Site Mitigation: Environmental Assessment ST/CAP Local Hazardous Waste Invest �azMat Pipeline Invest <br /> ther Lead Agency Site Agency: I �RWQCB I I DTSC I EPA PL Site �Wacer Quality Site 10ther Type Site <br /> DESIGNATED EMPLOYEE # Z, TPROGRAM ELEME1gT # 1�D CURRENT STATUS <br /> NUMBER OF UNITS EPA ID #: 1 INSPECTION CODE : <br /> Number of 'ASKS linked to this PROGRAM record : <br /> BILLING ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site and/or project specific <br /> PHS-EHD hourly charges associated with this facility or activity will be billed to the party identified as the BILLING PARTY on <br /> the Masterfile Record information Form. <br /> I also certify that I have prepared this application and that the work to be performed will be done in accordance with all SAN <br /> JOAQUIN COUNTY Ordinance Codes and Standards, State and Federal laws. <br /> APPLICANT'S SIGNATURE : <br /> Title: Date: �✓ I I <br /> AUTHORIZATION TO RELEASE INFORMATION: In addition to the above, when applicable, I, the owner, operator or agent of same, of <br /> the property located at the above site address hereby authorize the release of any and all results, geote2cbpical data and/or <br /> !at <br /> environmental/site assessment information to SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEAb 251'06 as soon as <br /> it is available and at the same time it is provided to me or my representative. <br /> gy 9 F� <br /> t QUIN('QUNT'f <br /> -'UCL <br /> DEADLINE DATES: Inspection: Current / / Prior / =tJ\ifPJJ�IE'�t;° .' F ITH DIVISIOV <br /> Fee Amount Amount Paid Date of Payment Payment Type Receipt # Check # Recvd By <br /> -2-3`� cn o <br />
The URL can be used to link to this page
Your browser does not support the video tag.
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).