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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 BILL OF LADING <br /> 3909 Park Road, Suite D <br /> Benicia, CA 94510 <br /> IVTAL SERVICES <br /> GROUP (877) 748-3040 <br /> P - �' •' t -'�� <br /> Western Region <br /> DELIVERY DATE JOB*4-t`a <br /> PHIPPER/CUSTOMER POINT OF CONTACT <br /> 01, 14f -rt ifs, <br /> DDRESS PHONE# <br /> .`fit=, r 9 f11; 11QV <br /> ITY STATE ZIP <br /> ARRIER/TRANSPORTER PHONE# <br /> iso fii ;T `r"PIti' <br /> ONSIGNEE I FACILITY POINT OF CONTACT <br /> k')VI1 AIM, tic{ <br />,DDRESS PHONE At <br /> `'391-; r Pi.7 i 4 � <br />,ITY STATE ZIP <br /> tt"� its <br /> i <br /> penal Handling Instruction and Additional Information <br /> k l� E l u W -i t 1 5 P 1+ 0_IR <br /> �� �� 4- � Vr.� ���� �AS3N aMi�,;s iki�. � ��� j64 Lr��k"_�l, ,, k+�A# )8�.';�� �G'{}§�F"i<<� f�„,� l�_ ,Y ��.PG <br /> M,q� 156$r t,4?-j9'1 117c) 595-7' i Pit ales �� nCui,P'� :t' R<72 <br /> lacards Provided YES NO Emergency Phone#(877) 748-3040 <br /> NIPPER'S CERTIFICATION t hereby declared that the contents of this Consignment are hilly and accurately descnbed above by proper shipping name and are classified,packed, <br /> Larked and labeled,and are to all respects to proper condition for transport by highway,vessel,and rail according to applicable international and national govemment regulations <br /> TIPPER}PRINT OR TYPE NAME - 'SIGNATURE _ r Mor+nr DAY yem <br /> TRANSPORTER}PRINT OR TYPE NAME SIGNATURE MONTH DAY YEAR <br /> , 1 <br /> f L f <br /> ;ONSIGN IUTY)P O TYPE NAME SIGIVA�LIR r or�F►r Y, craw <br /> 1 ” -7 11 <br /> arm It P C-2d1-RV 6104 !' <br /> SHIPPER <br />
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