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F'IMP Administrative Module <br /> Emergency Services <br /> Hazardous Materials <br /> Management Program <br /> e .r , <br /> y <br /> Business Site Information Review and Inspection Dates <br /> Business ID No. 13858 Ann'I Cert Sent 12/1/98 Duel 1/15/99 <br /> Business Name IQUIK STOP MARKET#39 Annual Cert Recd Date 2122/99 <br /> Address 12285 I E IFREMONT Correct Action Due Date I <br /> Street Type I ST Suite/Appt/Bldg I OES 10 Day Ltr I Duel <br /> City I STOCKTON State CA DA 10 Day Ltr I Due <br /> Zip Code 195205 Phone 1209-464-1038 Assigned Inspector ISTOCKTO FDCo.L_ <br /> Nature I CONVENIENCE STORE W/RETAIL, Last Insp Date 6/29/93 By <br /> Primary Contact (MIKE KARVELOT E-Mail <br /> Name nsp Follow Up Date_ By <br /> Status and Billing Codes Initial HMMP/Data Entry Controls <br /> Filing Type LY QY HMMP Status LIN REVIEW HMMP Packet Sent I <br /> Reg Sub On-Site NO RMP Status HMMP Due Date �_Rec'd L- <br /> Fire District 122 Annual HMMP Fee 1$85.00 . Data Entry Needed LYES Disk/E-Mail <br /> Trade Secrets IN IN Special Status Date Completed <br /> Billable Chems IIPrimary/Secondary 1 Person Completing <br /> I <br /> Waste Gen NO Fee Category ICOMMON Quality Assured By L_ Date <br /> HMMP Year 11999 Amended Bill 1 Annual Fee Billed By L_ <br /> Chems on File C ' ? Back Bill 1 Amended Bill Sent B L_ <br /> Y <br /> "page dowW' ke�additional information <br /> Same Mailing/Business Address <br /> Click in this box if the mailing address is the same as the business address, otherwise enter <br /> U the mailing address in the boxes below. (Leaving the check box unchecked) <br /> Mailing Address (Other than Business Address) ( Enter post office boxes as „t? O Box ), <br /> Address -4567 JENTERPRISE <br /> City EREMONT StatelCA ZipCodel94538 Phone 1510-657-8500 <br /> HMMP Review Verification and Special Instructions <br /> Review Sign Off Amended/Back Bill Instructions Data Entry Notes <br /> Annual Submit LOPEZ Date Chem Count I Fee Category I <br /> Reviewed By Changed From Changed From <br /> Other Submit 1 Date I Back Bill From To I <br /> Reviewed By <br /> Date Created Date Modified 2/23/1999 Last Modified By: Dennis Fields <br /> J <br />