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SITE INFORMATION AND CORRESPONDENCE FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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2575
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2900 - Site Mitigation Program
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PR0541989
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SITE INFORMATION AND CORRESPONDENCE FILE 1
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Entry Properties
Last modified
6/21/2019 5:10:28 PM
Creation date
6/21/2019 3:11:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 1
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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,fRBrt'-:ET I CENG I NEER I NG FRX NO. :19256024718 ,e. 23 2006 12:55PM P2 <br /> 03/22/2006 16:52 4640138 ENVIRONMENTAL HEALTH P86E 02 <br /> UA1t KLVWVFII \ CMWLl MjfflO m(yVPS� SAN JaAQaIN COUNTY <br /> (�� ENVIRONMENTAL HYALTY I DEPAItTMEN7eDo llAR I. <br /> V 304 East Weber Avenue,3"Floor,Stockton,CA.95202-270 23 Pr �2; 55 v► <br /> Telephone:(209)46&x420 Fax:(209)464-0138 Web:WWW cj6ov vrg�,hd <br /> Et4b, ROfy4 L:0UivTr <br /> PUBLIC RECO"S MEASE APPLICA'Tif 7H DEpn o TeJ I. <br /> y ,P„c <br /> X APPLICANT;�� '�[BUStNE5SU0ENGY:�„�m� J� <br /> �CADDR=: ZZ 1t''ly � -Grry20SG:T'f' <br /> ( PHDNF(f): q� COQ?ra K'1 L O X13 pxlloNe(a):g7.� 1 AcsxuLlti �Z3 (nd'Z,t{7 2b <br /> TENTATAPPOINTMENT DATE S (Z Time:JQ1�K1- <br /> IVE" <br /> (PI*as*9,10 bualMaa derya ff*M date of applleaNa+a nta -'Ten,,"*sly,mast be eemm'd) <br /> 7___�pY CHECK BOX TO EXPEMM ntM LRST-48 .00 E(CASH 05 CHEOK ONLY)-rtEOUeST PROCESSED N f USINESS DAY'$ <br /> K SIGNATURE OF APPLICANT DATE - �� <br /> FJe�itonlo <br /> atlon 0 LM U Map-Deecdpeon --� <br /> InfOlm <br /> FILE ADDRESS EHD USE ONLY <br /> Btro*ta 8 Nam* <br /> ❑ Unit 1 <br /> El Unit 2 <br /> s C Unit 3 <br /> B. <br /> ❑ Unit 5 <br /> 9. <br /> 10. ❑ Unt8 <br /> specific Date Rango of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT I'll ES <br /> tAiaKiRoIN o-wm(UST)CLamur Smi(LAP) 0 NO08IN0 ABATEMENT 0 Sono WABTa FActunIV060LA <br /> ER CLeANOP SMI("-LOP) 0 Foot FA0Iu7Y G WASP IM <br /> AO UNDERWoURP TANK(MONnORMKIM MOVAL) a DOG KENNEL 0 DAMY <br /> L1 KV.MA4Uf WAATEOENCRATon 00NI0KBN RANcN 0 WA0TEWATER7RGTRNTPLNn <br /> 0 TIERW PERMITTED FACILRT ZMOWOMML ❑PDa/PERTRUCNIYAFW�EleOAL ttarTa <br /> 0 TAT MOMODY PERaMO 0 PQ"PA 0 LAAB U0 APPLICAT"SITIS <br /> 0 MEDICAL WASTE FACUry 0 OTHER(PLEASE SPNORY) <br /> wFLL AND SSPno PEWrr REGOROS ARE AW,00 FOR RFAM-MONDAYdaDAY e:00 AMS:O" - EKOLOINNG HOUDAYe. <br /> 1. Llst up to ten addresses in the space above., Select the type(s)of files from the list above by checldng the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(20914841)128 or me1119the addnss <br /> Indloated abovo. Address ranges will not be accepted—for additional assistance with file addressee,contact <br /> tho ENP.Applications received after B:oO pm will be processed the next buSlness day, <br /> 2. The EHD will notify the applicant R Any EHD files exist. An appointment for review will be confimted <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five bvilness <br /> days for review. Appointments should be scheduled accordingly. <br /> S, A file that is actively being worked on by EHD staff may not be Immediately availabl a for review. A ney, <br /> appiicatlon may be submitted when the file is available. <br /> 4. Any file not rotumed in the same condRlon as released will be reorganized by E14D stare at the expense of the <br /> applicant Future file reviews by the acme applicant may require a$93.00 depoelt prior to review. <br /> 1 <br /> EN*+aas <br /> �omr�s <br />
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