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ARCHIVED REPORTS XR0003472
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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ARCHIVED REPORTS XR0003472
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Entry Properties
Last modified
6/21/2019 9:16:46 PM
Creation date
6/21/2019 3:34:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003472
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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3 <br /> 1 a <br /> GEM <br /> 3909 Park Road, Suite D BILL OF LADING <br /> SIVIRONNIEr-TAL SERVICES Benicia, CA 94510 <br /> CROUP (877) 748-3040 <br /> Western Region <br /> DELIVERY DATE dpg ! <br /> iHIPPER/CUSTOMER POINT OF CONTACT <br /> J. OI PR( —CfL US "14 <br /> =%DDRytESSPHONE# <br /> L 7'fdri <br /> NTY STATE ZIP <br /> :ARRIER/TRANSPORTER PHONE# <br /> ��'a;4"�,�.��"i•_ t*}'.�3U{:3's`I�`�`�515 vN� ���_ 4 c� s <br /> ;ONSIGNEE/FACILITY POINT OF CONTACT <br /> FQIRI ARDI, i`lefi'. <br /> ODRESS PHONE# <br /> :ITY STATE ZIP <br /> y p'n <br /> ,r 1[ <br /> 3 <br /> • <br /> r <br /> pedal Handling Instruction and Additional Information <br /> 41 91=i°Y,.1.X 0@ N04 nAXW)OK MfF SOL— I 5('a lEfiru�7fpm-a���p'm) •It d nopu Wl,-WT-M C!074 W" fiYCFRGI RKSFn'ISa <br /> ?Iif'P;n AM) <br /> 1acards Provided YES NO Emergency Phone#(877) 748-3W <br /> HIPPER S CERTIFICATION i hereby declared that the contents of this consignment are fuly,and accurately described above by proper shipping name and are classified packed, <br /> larked.and labeled and are in all respells in proper condition for transport by tughway,vessel and rail according to applicable international and national govemmeM regutaLons_ <br /> SHIPPER)PRINT OR TYPE NAME r - _ < SIGNATURE Jr,s;' — MoNm DAY Yaw <br /> _ s r X <br /> ;ARRIERITRANSPORTER)PRINT OR TYPE NAME' SIGNATURE V�: MoNm DAY <br /> X { n <br /> ,O1V51 NEE/FACIL ITyrJ(( PRINT OR TYPE NAME SIGNATURE MONTH p,v YEAR <br /> 77 I <br /> 1 � ' j <br /> X j f J4 ! <br /> DM#r SC-201-RV 6/04 r € <br /> SHIPPER <br />
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