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SU0004897 SSCRPT
Environmental Health - Public
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2600 - Land Use Program
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SU-01-07
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SU0004897 SSCRPT
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Last modified
5/7/2020 11:31:19 AM
Creation date
9/6/2019 10:30:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0004897
PE
2611
FACILITY_NAME
SU-01-07
STREET_NUMBER
11501
Direction
E
STREET_NAME
JAHANT
STREET_TYPE
RD
City
STOCKTON
APN
00715027
ENTERED_DATE
3/9/2005 12:00:00 AM
SITE_LOCATION
11501 E JAHANT RD
RECEIVED_DATE
3/8/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\J\JAHANT\11501\SU-01-07\SU0004897\SSC RPT.PDF
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EHD - Public
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23. Based upon a review of Fire Insurance Maps or consultation with the local fire department <br /> serving the Property, all as specified in the Guide, are any buildings or other improvements on <br /> the Property or on an Adjoining Property identified as having been used for an industrial use <br /> or rues likely to lead to contamination of the Property? Yes rNo N/A <br /> The Preparer of the Transaction Screen Questionnaire must complete and sign the following statement (For definition of <br /> "Preparer" and"User", see Section 5.3 of this Standard Practice or Section 3.3.25). <br /> Y THIS QUESTIONNAIRE WAS COMPLETED BY <br /> Name <br /> aa' �jls M <br /> TitleFiQAddres <br /> _ Phone Number ' <br /> IF THE PREPARER IS DIFFERENT THAN THE USER, COMPLETE THE FOLLOWING: <br /> .. Name of User <br /> User's Address <br /> Users Phone Number <br /> Preparers Relationship to Site <br /> Preparers Relationship to User(e.g.,Principal,employee,agent,consultant) <br /> COPIES OF THE COMPLETED QUESTIONNAIRE HAVE BEEN FILED AT: <br /> COPIES OF THE COMPLETED QUESTIONNAIRE HAVE BEEN MAILED OR DELIVERED TO: <br /> 7 Match 17. 1994 <br /> 24-160512-A00 DM18-lw(1994) <br /> tUnk=Unknown or No Response <br />
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