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SU0006411 SSCRPT
Environmental Health - Public
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SU0006411 SSCRPT
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Last modified
5/7/2020 11:32:22 AM
Creation date
9/5/2019 11:17:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0006411
PE
2622
FACILITY_NAME
PA-0700009
STREET_NUMBER
17
Direction
N
STREET_NAME
HINKLEY
STREET_TYPE
AVE
City
STOCKTON
Zip
95215
APN
15721022
ENTERED_DATE
1/30/2007 12:00:00 AM
SITE_LOCATION
17 N HINKLEY AVE
RECEIVED_DATE
1/30/2007 12:00:00 AM
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\rtan
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FilePath
\MIGRATIONS\H\HINKLEY\17\PA-0700009\SU0006411\SSC RPT.PDF
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EHD - Public
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08/31/2006 14:05 120956' X27 MIRAMAR R.E. BRA' —RS PAGE 08/08 <br /> .� TUE AUG 29, 2008 01 :5�10-0 ./ PACE 11 <br /> Surface and Subsurface Contamination Report questionnaire <br /> NOA Project Number: E06096A <br /> Property Location: 17 N. Hinkley Ave.. 5tockton, CA 95215 <br /> Page 11 <br /> 2. Have pesticides, herbicides or other agricultural chemicals been nixed, ❑ Yes [�No <br /> formulated, rinsed, or disposed of on the property? If so, please <br /> describe the locations where such pesticides, herbicides or chemicals <br /> were mixed, formulated, rinsed, or disposed, and the type of <br /> pesticides, herbicides or chemicals mixed, formulated, rinsed or <br /> disposed of at each location. <br /> 3. Has any soil or groundwater analysis been performed to detect ❑ Yes No <br /> pesticides, herbicides or chemicals used at the site? If so, please <br /> provide a summary of the findings or attach the report(s). <br /> ENDORSEMENTS: <br /> Part 2 <br /> As the present owner of the property or as an officer or general partner of the present owner of the <br /> .- property(or the duly authorized representative of such owner), I am fanMliar with all of the operations <br /> presently conducted on the property. and hereby certify that to the best of my knowledge, <br /> Information, and belief the information disclosed above is true and correct. <br /> ne r e Maa=nager's Signature Date <br /> Owner or Key Site Manager's Name (please print) <br /> TITI fmm� <br /> lfrnrr hmr mt.v pnesNnns rtAan!this prreanonnNrt,plrnsvr fartnCr a'lrrn Charrrr mx309!365•3707 cel.133, <br /> r <br />
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