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REMOVAL_1995
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4 (STATE ROUTE 4)
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21334
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2300 - Underground Storage Tank Program
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PR0506032
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REMOVAL_1995
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Entry Properties
Last modified
11/20/2024 9:08:20 AM
Creation date
11/5/2018 10:35:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
1995
RECORD_ID
PR0506032
PE
2381
FACILITY_ID
FA0007159
FACILITY_NAME
KINGS ISLAND
STREET_NUMBER
21334
Direction
W
STREET_NAME
STATE ROUTE 4
City
STOCKTON
Zip
95206
APN
12919002
CURRENT_STATUS
02
SITE_LOCATION
21334 W HWY 4
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\F\HWY 4\21334\PR0506032\REMOVAL 1995.PDF
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EHD - Public
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3-11-1996 6 37P FROM O'NEILL-INVESTIGATIV 7986050 P.] <br />12, <br />13. <br />What Is the deptb to =Tin FT. <br />Deserlbe the mum or hstarmadm: <br />V � Sl�faL <br />Are there any wafer wdb an this pwcal er ASCW PrapaetltET <br />1YP6 Ol WE(18 <br />D1*CAP1C62V'1:ATtg'd(� <br />Public Well <br />IL <br />PrNab Wdl <br />R <br />hT%FLdaa Well <br />R <br />Moottoving Wen <br />It. <br />Outer <br />tL <br />YRS I ) NO <br />14. will the tank(s) pending doeum be rept" with an abtwegjetmd or urliwpauM storage tank(s)? YES[ ) NA <br />15. Indicate the responsible part' to be Wed tor additional PIME® shR thus wgnndad beyond 3 hoar mialmom <br />penult payment per tank. U the p orty deslgusted bdow is dUkrunt shoo dw perm* oppl►asab ad• prop rly owner, <br />the party must edmowbfte this rssputtdblUty tar the btWng by d<naten m d dote below. <br />Name P\rad..,%E tC%61G Qjb S1J�1 �t f�iElIt e�RJSiEE <br />Making Address 22(e 3�0 q5r%OGPr <br />>` 1 Uf%5ftn1T mak%" 1 CEi 1 4 <br />Day Phone Number ( SI b ) r)q 8 w Z z (o <br />Y�� <br />Signature <br />Page 6 <br />1.0 39vd 3tl1N3W4Qd1AN3 1H91eiM <br />80 39vd 'rolN3dN0NV%N3 1H9IMM <br />.,Y -/i y(- <br />Dat <br />ZSTSZ£86OZI SZ:80 9661/bZ/T0 <br />Z9T97.rRFG7T R7 :PR cccT7v rTR <br />
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