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SITE INFORMATION AND CORRESPONDENCE FILE 2
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 2
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Last modified
6/21/2019 5:41:47 PM
Creation date
6/21/2019 3:17:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 2
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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. << zuvy [:7ory Hovanceo ueotnv ronmental No. 6143 F. <br /> DATE RECEIVED #E11BER <br /> NI,M <br /> �., SAN JOAQUIN COUNTY vw <br /> ENVIRONMENTAL HEALTH DEPARTMENT �1 <br /> 600 East Main St. Stockton, CA 95202-3029 /� <br /> UtL: E 4 2009 Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENVIRvPIW4444441 PUBLIC RECORDS RELEASE APPLICATION <br /> PERAW$WF�ly colavita BUSINESS/AGENCY: Advanced Geo&nvironmental, Inc. <br /> ADDRESS: 831 Shaw Road CITYISTATE/ZIP: Stockton <br /> PHONE(1): 209-461-loa6 PHONE(2): 209-493-3401 FACSIMILE: 209.467.1118 <br /> TENTATIVE*APPOINTMENT DATE: AsAe Time: <br /> (Please allow 10 business days from data of application submittal-•Tentadve only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$1 5 F E(C�,�H CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � � DATE 12/24/09 <br /> Electronic Information: ❑List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> $treat P Street Name city ❑Unit 1 <br /> 1. 2575 Country Club Boulevard Stockton <br /> 2• 0 Unit 2 <br /> 3. <br /> 4. nit 3 <br /> 6. <br /> 1 <br /> s. � ❑ 4 <br /> T. <br /> e. <br /> - _ Q Unit S <br /> 9. <br /> 10. <br /> nit S <br /> Specific Date Range of Information Requested: From to <br /> �-�t' ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> L�uNDEROROUN0 TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Yr�SOUD WASTE FACIUTYNEHICLE <br /> OTHER CLEANUP SITE(NON•LOP) [:1 FOOD FACILITY &%ASTETIRE <br /> UNDERGROUND TANK(MONITORINOIREMOVAL) ❑Doe KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH El WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑yTATT00180DY PIERCING ElPOOLISPA [:1 LAND USE APPLICATION SITES <br /> LJ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPnt(EXCLUDING HOLIDAYS) <br /> 1. List uD to ten addresses In the space above. Select the type(s)of Ries from the list above by checking the appropriate <br /> box(sa). At least one file type MUST be selected. Fax to(208)464.0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD flies exist. An appointment for review will be confirmed approximately ton (10) <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4. Any file not retumed In the same condition as released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> 6. If you need further assistance,please contact Diane Martinez,at(208)468-3426. <br /> EMD USE ONLY <br /> EHO re.ue <br /> BI]r/a9 <br />
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