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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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BILL OF LADING <br /> 3909 Park Road, Suite D <br /> Benicia, CA 94510 <br /> �TVIRONMETFFAL SERVICES (877) 748-3040 <br /> GROUP <br /> Western RMon ; <br /> DELIVERY DATE JOB � .3 <br /> iHIPPER/CUSTOMER POINT OF CONTACT <br />�ODRESS PHONE <br /> :ITY STATE ZIP <br /> ;ARRIER/TRANSPORTER PHONE# <br /> lkj' <br /> :ONSIGNEE/FACIL-ITY POINT OF CONTACT <br /> kDDRESS PHONE# <br /> <19L1'-i 5 01 ':1 l,d "0;arl <br /> :ITY STATE ZIP <br /> aw <br /> CA WiAC <br /> IN 1:11ij <br /> Eli <br /> 3 <br /> r <br /> }� S <br /> pecnal Handling Instruction and Additional Information <br /> YjE9 0 - Oft ;1;i7MDO'5 ;EA3Tz 80 4 U1 MHw ?xk-GPAVE't I ina i 19P PCPv< "M A, <br /> ""fly 571-$77a Mill <br /> lacards Provided YES NO Emergency Phone#(877) 748-3040 <br /> NIPPER S CERTIFICATION i hereby declared that the contents of this consignment are fully and accurately described above by proper shipping name and are classified parked, <br /> narked and labeled and are in all respects in proper condition for transport by highway vessel and rail according to applicable international and national govemmertt regulations <br /> SHIPPER)PRINT OR TYPE NAME, SIGNATURE , <br /> f � = � ���� � 1 MONTH MY YEAR <br /> w4RRIER/TRANSPORTER)PRINT OR TYPE NAME 4 SIGNATURE` � MONTH DAY <br /> DON"EE Acl PRINT OR TYPE:NAME SIGNATURE _ MONTH DAY YEAR <br /> r S t } f li r / <br /> t 1 = X fr _ LIL <br /> I` k f /i <br /> orm#PSC-201 -RV 6/04 <br /> SHIPPER <br />
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