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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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j 4 <br /> 2 <br /> i <br /> BILL OF LADING <br /> 3909 Paris Road, Suite D <br /> VN;AL SERVICES Benicia, CA 94510 <br /> GROP (877) 748-3040 _:z_ 5 rct ; <br /> Weston Region <br /> z <br /> DELIVERY DATE JOB <br /> SHIPPER/CUSTOMER POINT OF CONTACT <br /> OTT <br />#DDRESS PHONE# <br />'.ITY STATE ZIP <br />:ARRIER/TRANSPORTER PHONE# <br /> k-LE <br /> Irp scgc rtt2"s /" i> t *;.` ' 7#,�"I 1I 'P z r#Wi <br />:ONSIGNEE/FACIUTY POINT OF CONTACT <br /> •'f Apt"' <br />>DDRESSAll,-41- PHONE# <br /> hh t <br /> TITY,GSTATE ZIP <br /> ', w <br /> 4N ItAVKWIVI IAM <br /> 3 <br /> 1 <br /> J <br /> 1 <br />,pedal Handling Instruction and Addrhonai Information <br /> a' L.*XFT$,.r,Y-30 - W14 it1iURIMN WO" MAD Ute�, )lttOtP4 "YNC111;E c"iQ?P13�1 WRL-RVIF ��:���;►r <br /> OMIF jM1 F$? '171;; cf� 1'17 1()QftRj i'l,''IPVb'ltt'W #A484 <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 stupprng name and are classdfed.packed. <br /> narked.and labeled,and are in all respects in proper condrhon for transport by tughway vessel,and rail according to applicable rntemaironal and rational government regulations <br /> SHIPPER)PRINT OR TYPE NAME r - <SIGNATURE MOtrM onY YEM <br /> Cie R(TRANSPORTER)PRINT OR TYPE NAME _ siGNATURE -, ' - MONTH DAY YUA <br />{ X <br /> CON�GN AJUTY)PRINT OR TYPE NAME SIG"TURE MONTH v YEAR <br /> Ix fly <br /> y � <br /> orrfS#PSC-201-RV 6/04 <br /> SHIPPER <br />
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