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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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F-R":EfICENGINEERING 11%, FAX NO. :19256024718 IWO-. 23 2006 12:55PM P2 i/' <br /> 03/22/2006 16:52 4640139 ENVIRONMENTAL HEALTH PAGE 02 <br /> UA It t<CL'klVhll <br /> SAN JOAQUIN Cocn4 Lanz,1'JmoCR <br /> tmrr�t #16 <br /> ENMONMENTA LHEALTH IDEPARTMEKC6O�p�AR 23 Py d` <br /> V' 304 Fast Weber Avenue,3 Floor, Stookton,CA 95202.270 12; 5S <br /> Telephone:(209)458-3420 Fax:(209)454-0139 web:www ajoi%+OmJ14,bd <br /> Fi,'S'IROryHE COU1yf <br /> PUBLIC RECORAS MEAHE APPLICAT( 'H Dt P n n r.n L <br /> X APPLICANT: d xsUSTNES5IA0ENCY:y . -C ,✓wl H . [j✓1Gc <br /> ADDRESS: ry ZZAry�n�7�IrI��4XJ <br /> .( PHOHE(1): gZ15, � ?—Jq [01-D.PHONE(xl:7, CS wAItn,RZ3L(nOZ,r{7? D <br /> TENTATIVE'APPOINTMENT DATE:�t f r 'CU 5 LL Tmc IV 0411 <br /> (Please A w td basimmz days from date of appfluNan a -'Te0$*VW any.must be ewrmed) <br /> 7'--� CHE0K BOX T:D E%PF"rE FU LM:ST-0 .00 F E(CASH 0 PROCESSED ONLY)-REOUEBT PROC &ED IN I U51NESS DAYS <br /> X SIGNATURE OF APPLICANT ! F DATE <br /> ElaLttortic ❑ Ust U Map-Desorlpnort —� <br /> IMormaOon <br /> 11LE ADDRESS END USE ONLY <br /> scoot e <br /> GbW Noma Cit3r <br /> ❑ Unit 1 <br /> El Unit 2 <br /> s Q Unit 3 <br /> 6. <br /> ❑ Unit 5 <br /> 9. <br /> iD. ❑ Unft 6 <br /> Specific Date Range 0f Information Requested:From re to _,...�. <br /> ENVIRONMENTAL HEALTH DEPARTMENT FPLES <br /> ❑Ho=nk;ABATEMENT O SOLm WAins FACIUrTfVETmta <br /> ur ER CL <br /> AMTANK(VSn LOP) P SI E(LOP) G WASTE TM <br /> ER CLeAry+lc artR(NoH•I.OP) ❑ ra0e FA0AJTY <br /> G UWDER0F=W TANK(MONROMMO REMOVAL) a Ooc KE7 MEL n0 DAIRY <br /> 11 HAi Uf WA$TE WHIRATOR l]CWCrrN NANCMWA4TEWATTiR TRrJ�TMENTPwri <br /> ❑TIERrD PERarrrW FADIUrT Ll MOTELIHOTEL 0 PUMPERTRucwYAF.Wc-- CALT"u Tb <br /> 13 TATTOOMMY PI IK" 0 PoDLtsm L)LAND UGG APPLICAU M SIM <br /> ❑MEw-ALwASTE FAciLm 0 OTHM(PLEASE SPGORY) — <br /> WGLL AHD aGPTID PEaMIT RE FMS ARE AVAILMLA roR REVIEW-MONDAY4FMOAY e:ta AtA-S:Oaru - EXCIAIIMiC HDLRIAYS. <br /> 1. List up to ten addresses in the space above.. Select the VPO(s)of files from the Prat above by checldny the <br /> appropriate box(es). At least one file type MUST <br /> be selected. )_ax to(209)4844/130 or mall Ao the addmss <br /> Indicated above. Address ranges wilt not be accepted—for additional assistance with file addresses,contact <br /> the EMP.Applications received atter 9:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applleant If any EHD files exist An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maxlmum of five tIV31ness <br /> days for revlaw. Appointments should be echeduled accordingly. <br /> 9. A file that is actively being worked on by EHD staff may not be immadiately available for review. A ney, <br /> application may be submitted when the filo is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff et the expense of the <br /> applicant Future file reviews by the eame applicant may require a$93.00 deposft prior to review. ` <br /> IX0 X846 <br /> 1M1fia06 <br />
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