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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 & Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E05150A ft E051 50B <br /> Property Location: 5113 Et 5153 E. Main Street, Stockton, CA 95215 <br /> Page 11 <br /> 2. Have pesticides, herbicides or other agricultural chemicals been mixed, ❑ 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 familiar 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 /> ///7 /4 4- <br /> Owner or Key Site Manager's Signature ate <br /> I La ,• n-� <br /> .� Owner or Key Site Manager's Name (please print) <br /> Ca <br /> "Title, Corimpany —� <br /> Ifyou have any questions about this questionnaire,please contact Abby Rocco at(209)367-3701 est.138. <br /> Y '404 <br />
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