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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ELEVENTH
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103
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3500 - Local Oversight Program
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PR0544750
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
11/19/2024 10:19:50 AM
Creation date
8/12/2019 2:13:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544750
PE
3528
FACILITY_ID
FA0003706
FACILITY_NAME
CHEVRON USA #90959 (INACT)
STREET_NUMBER
103
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95476
APN
23313023
CURRENT_STATUS
02
SITE_LOCATION
103 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Cl <br /> /2412014 i 1:22 Advanced GeoEnviromental Inc. (FAX)209 4671118 P.0011001 <br /> VED EHD LOG NUMBER <br /> SAN,�OAQUXN COUNTY Q. <br /> AUG ? 4 2010 ENVIRONMENTAL HEALTH DEPARTMENT <br /> E.NVIRONP0 a HEAL ' 600 East:MainStreet, Stockton, CA 95202--2708 <br /> {� AAn-I .�'-.` •1-�flY• VeIepllone; (209)468-3420 Fax: (209)454-0138 Web: vv.sjgov.org/ <br /> / PUDLIC RECORDS RELEASE A�'PLtCATION <br /> 5' <br /> APPLICANT; t�I` , 1 BU81NESWAOENCY: j4r6' <br /> ADt}t2t SS: ? ' <br /> PHONE(1),.. 'firl._ PHONE(2): FACSIMILE: 6 <br /> TENTATIVE*APPOINTMENT DATE; Time: <br /> (Please allow 10 business days from date of applioation submittal-*Terttaflve only-must be confirmed) <br /> b CHECK BOX TO EXPEDITE REQUEST-$9100 FEE(CASH OR CHECK ONLY)-REQUEST f ROCFSSED IN 3 6 INESS YS <br /> SIGNATURE OF APPLICANT DATE ? 72 <br /> Electronic Informatlon. ❑ List❑ Map—Description: <br /> FILE ADDRESS E FID USE ONLY <br /> Street 1i Street Name City . it 1 <br /> 6�5 <br /> a n <br /> 1. {C73 (1'lT <br /> 2 PLUnit 2 <br /> 3. <br /> Unit 3 <br /> 4. <br /> 6. <br /> 7` Unit 5 <br /> 9• t e <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILLS <br /> UNDEROROUND TANK(UST)CLEANUP SITF(LOP) 13 Houswo ABATEMENT XSoLID WASTE FACILJTYIVEHICLE <br /> Rr THEK CLEANUP SITF(NON-LOP) Q FOOD FACILITY Q WASTE TIRE <br /> NDERGROUND TANK(MONITGRINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> IaARI50U8 WASTE GENERATOR d CHICKEN RANCH 0 WASTEWATER TREATMENT VLANT <br /> TIERED PERMITTED FACILITY Cl MBTELlHOTEL 0 PUMPER TRUCKIYARDICHEM ToILETs . <br /> d TATMISODYPIVROINO 171 POOLISPA M LANDUseAPPLICATIONSlTE9 <br /> *MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT REC01b9 ARE AVAILABLE FOR REVIEW -MONDAY-FRIDAY 8:00 AM-5:00RM - EXCLUDING HOLIDAYD. <br /> 1., Llst up to ten addresses In the space above, Select the type(s)of files from the list above by checking the appropriate <br /> box(os). At least one file type MUST be selected. Fax to(2091464-0136 or mall to the adds indicated above Address <br /> ranges will not be accepted--for additional assistance with file addresses,contact the EHD.Application received after <br /> 3:00 pm will be processed the next business day. <br />` 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> k days after recelpt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by FHD staffmay not he immediately available for review. A now application may be <br /> submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br />` <br /> EHD USE ONLY <br /> "!e if otl should need further assistance please contact Diane Martinez a (209)468-34x5 direct± . Thank You'" <br /> L9-06 911412006 <br /> _ 1 <br />
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