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SR0084566_SSCRPT
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SR0084566_SSCRPT
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Last modified
12/29/2021 1:47:31 PM
Creation date
12/29/2021 1:43:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SR0084566
PE
2603
STREET_NUMBER
18201
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
MOUNTAIN HOUSE
Zip
95391
APN
20945035
ENTERED_DATE
12/6/2021 12:00:00 AM
SITE_LOCATION
18201 W GRANT LINE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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6 1 Page <br />If any of questions 3.a -d are answered "yes,"please provide a description, <br />including the location of all disposal sites, treatment facilities and storage <br />areas, the type of chemicals or wastes handled at each site, the results of <br />any soil or groundwater samples taken in the vicinity of each site, and the <br />manner in which each site not presently in use was closed. <br />AGRICULTURAL PROPERTIES <br />Yes No <br />1. Is the property currently used for agricultural purposes, other than ❑ <br />grazing or pasture land? <br />2. To the best of your knowledge, has the property been used in the past for ❑ <br />agricultural purposes, other than grazing or pasture land? <br />3. If the answer to either question is "yes," please answer the following: <br />a. Have pesticides, herbicides or other agricultural chemicals been <br />applied to the property? If so, please describe the locations where <br />such pesticides, herbicides or chemicals were applied, and the type ❑ ❑ <br />of pesticides, herbicides or chemicals applied in each area. (Please <br />attach copies of pesticide use reports if available.) <br />b. Have pesticides, herbicides or other agricultural chemicals been <br />mixed, formulated, rinsed, or disposed of on the property? If so, <br />please describe the locations where such pesticides, herbicides or <br />chemicals were mixed, formulated, rinsed, or disposed, and the type ❑ ❑ <br />of pesticides, herbicides or chemicals mixed, formulated, rinsed or <br />disposed of at each location. <br />C. Has any soil or groundwater analysis been performed to detect <br />pesticides, herbicides or chemicals used at the site? If so, please ❑ ❑ <br />provide a summary of the findings or attach the report(s). <br />DOCUMENTS/PROCEEDINGS <br />Copies to be <br />Yes No provided? <br />1. Available Documents <br />Are you aware of the existence of any of the following documents <br />for the subject property? If so, please indicate whether you can ® ❑ <br />provide copies of those documents to this office within reasonable <br />time and cost constraints. <br />lv.petralogix <br />26675 Bruella Road • Galt CA 95632. 209.400.5729 IMMEMEM <br />
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