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SU0007489 SSCRPT
Environmental Health - Public
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SU0007489 SSCRPT
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Last modified
5/7/2020 11:33:05 AM
Creation date
9/6/2019 10:02:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0007489
PE
2622
FACILITY_NAME
PA-0800348
STREET_NUMBER
21301
Direction
N
STREET_NAME
MANN
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
01728010
ENTERED_DATE
11/25/2008 12:00:00 AM
SITE_LOCATION
21301 N MANN RD
RECEIVED_DATE
11/24/2008 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\M\MANN\21301\PA-0800348\SU0007489\SSC RPT.PDF
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EHD - Public
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� 3 <br /> Surtace/5ubsurtace Contamination Report Ouestionnalre <br /> IR Squared Project Number - 2008015 <br /> Property Location - 21301 N.Mann Road,Acampo,CA <br /> ENVIRONMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART TWO OWNER INFORMATION <br /> (To be completed b% Owner or O%mer's representative) <br /> I. GENERAL INFORMATION <br /> Current owner of propeny <br /> Name C_h['.e-Je 5 1✓ - S-rc�r ,r <br /> Address ,3 t N. yr1 ,1 Krl A Ca rKp c, CA 9S i z-D <br /> -1 eiephone U 1 '3 2_1 - ? -1 '1 <br /> Year purchased 2006 <br /> 2 PREVIOUS OWNER(S)AND C'ONTAC'T INFORMATION(if known) <br /> Name A Mb-e_,� L a ren+-ma 1 Gtr <br /> Address PC) Bo vL y 3 Ce.re y Mu v o d l D 3 <br /> 'Ielephorn 2 0r 4o V 3 - to 1 9 <br /> Year Purchased B 19915- <br /> 3. <br /> 9gS3. OTHER PERSON WITII KNOWI.EDGEE OF PROPERTY <br /> Name C l IckY'\t'_,> J i-c r Y -I[ <br /> Address ;t I(o 3 N Zvi a n rt A Ca vi p o <br /> 7"c lephone <br /> Retati(xishipto property QW n pr-e-vi ou $ {-[) i3 re I ma 1 G,I' <br /> 4 Please describe current use(s)of propert% <br /> re5,d e rA-i ccA h o Lc 5 a ex 8 rt e, . <br /> Ir^cN1ti,Yttt7r� aro�7w-}�' )ri V1Me-yekr,I, <br /> a Please describe any other known past usels)of property,and approximate dates of each use <br /> 1/tvieVzLY- l �vr- + zn ygar-S <br /> IR SQUARED CONSULTING,INC. FNVIRONMIF.NTAI.-ENGINEERING•GEOLOGY <br /> 6532 MlCNEIL COURT,VALLEY SPRINGS,CA,45252 PHONE(204)772 31141 FAX(204)740 4303 <br />
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