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SU0005331 SSCRPT
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SU0005331 SSCRPT
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Last modified
5/7/2020 11:31:37 AM
Creation date
9/6/2019 10:01:03 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0005331
PE
2611
FACILITY_NAME
PA-0500543
STREET_NUMBER
5113
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
STOCKTON
Zip
95215
APN
15910004 & 06
ENTERED_DATE
8/24/2005 12:00:00 AM
SITE_LOCATION
5113 E MAIN ST
RECEIVED_DATE
8/23/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\M\MAIN\5113\PA-0500543\SU0005331\SSC RPT.PDF
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EHD - Public
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Phase I Et Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E05150A £t E05150B <br /> Property Location: 5113 8 5153 E. Main Street, Stockton, CA 95215 <br /> Page 5 <br /> NEIL 0. ANDERSON It ASSOCIATES, INC. <br /> ENVIROMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART 2: OWNER INFORMATION <br /> (To be completed by Owner or Owner's representative) <br /> I. GENERAL INFORMATION <br /> 1. Current owner of property <br /> Name: l oc,k�� �C+e✓— M0.1 N L <br /> Address: 610 Vi <br /> _ Telephone: 4??,,5- 516-Woc> <br /> Year purchased: ?i0V S <br /> 2. Previous owner(s) and contact information (if known): <br /> (s <br /> Name: C�/y�K^ -5 CLQ-✓G^ll�C <br /> Address: 10-5(4 <br /> Telephone: <br /> Year purchased: <br /> 3. Other person with historical knowledge of property: <br /> Name: <br /> Address: <br /> Telephone: <br /> Relationship to property: <br /> 4. Please describe current use(s) of property: <br /> `. 5. Please describe any other known past use(s) of property, and approximate dates of each use: <br /> /jyou have any questions about this questionnaire,please contact Abby Racco at(209)367-3701 ext. 238. <br /> V <br />
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