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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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I%�RY PM Ha ss Environmental , Inc 51 349098 P. 1 <br /> H 'V EHO L00 NUMBER <br /> I%SE RECEIVED <br /> 'a JAN 27 2015 SAN .IOAOUIN COUNTY Ir ENVIRONMENTAL HEALTHDEPARTMENT PAWENVIRONMENTALII-��Tit 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> PERMITISERVIVi6one: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: SAM Loon.,? BUSINESS/AGENCY: %ASIC-S 1<rJv ReuNL6AA/IAL,111L• <br /> ADDRESS: 6SS 12TH STREcr , S"Tiz 12 f, \ CITY/STATE/ZIP: OAKutND , cA 9460 <br /> PHONE (1): 101834_-c1o°t°1 PHONE (2):�SG �lto1 ^LlrlCil FACSIMILE: (SIb) 834 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑CHECK BOX TO EXPEDITE REDO -$130 FEE(CAS R CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE I <br /> Electronic Information: ❑ Llst ❑ Map— Description: <br /> FILE ADDRESS END USE ONLY <br /> Street t Street Name City i Unll1 <br /> 1. 17 S"ICi C - Q CL colo orJ I(JJ <br /> 2. Lin unt 2 <br /> 3.4. � <br /> 5. <br /> & r2finit 4 <br /> 7. <br /> 8. unit e <br /> 9. <br /> Specific Date Range of Informatlon Requsatad: From to <br /> �/ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES ���� <br /> �1�)fiDEROROUNDTANK(UST)CLEANUPSITE(LOP) 2NEDICALWASTEFACILITY L�'Jo9 LIDWASTEFACILrTYfVEHICLE <br /> THLRCLEANUPSITE(NON•LOP) ❑HOUSING ABATEMENT []'WASTE TIRE <br /> DEROROUND TANK(MONITORINOIREMOVAL) ❑FOOD FACILrrY ❑DAIRY <br /> BOVEOROUNDTANK ❑CHICKEN RANCH/DOD KENNEL TREATMENTPLANT <br /> RDOUS WASTEIHAZARDDU$MATERIALS ❑M/yOTELIHOTEL ZA&TEWATER <br /> MPER TRUCKJYARDICHEMICAL TOILETS <br /> ERED PERMITTED FACILITY ❑ OOIISPA N <br /> PD USE APPLICATION SITES . <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 13:00 AM-S:OOPM(EXCLUDINQ HOLIDAY@) <br /> 1. List uo to ten adglgp_qftA In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file,type MUST be selected. Fax to 2081 454-0135 or mall to the addraaslndicated above. Address <br /> mngie will not be accepted.Applications received atter 3:00 pm will be processed the next business day. <br /> 2. For peslstence In Identifying the nature and content of EHD records, please Contact END at the number noted above. <br /> 3. The END will notify the applicant It any END flies exist. An appointment for review will be confirmed approximately ten(10) <br /> days atter racelp-t of applluallon. The files will behold for a maximum of five bualnses days for review. AppolntnNnts <br /> ,Should be scheduled accordingly. <br /> 4. Any file not returned In the some condition as released will be raorganIxed by END staff at the expen"of the applicant. <br /> Future file reviwNa by the Isms appllennt may require a 3130 deposit prior to review. '•`ISOXED AREA-EMO USE ONLY••• <br /> Q Records provided b'y Staff-PPR Complete.staff Name: <br /> 2 ece-ived Timm,=Jan. 26.2015= 4: 54Pf1/1=No. 7.958- <br />
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