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SU0005947_SSCRPT
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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2600 - Land Use Program
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PA-0600098
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SU0005947_SSCRPT
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Last modified
11/19/2024 3:46:25 PM
Creation date
9/9/2019 10:24:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0005947
PE
2622
FACILITY_NAME
PA-0600098
STREET_NUMBER
20899
Direction
E
STREET_NAME
STATE ROUTE 12
City
CLEMENTS
APN
02311024
ENTERED_DATE
3/7/2006 12:00:00 AM
SITE_LOCATION
20899 E HWY 12
RECEIVED_DATE
3/7/2006 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\20899\PA-0600098\SU0005947\SSC RPT.PDF
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EHD - Public
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6. <br /> i <br /> Phase I Site Reconnaissance Checklist <br /> NOA Project Number: E05144A <br /> Page 4 <br /> j 13. a.Are there any open or damaged containers containing unidentified substances observed on the subject <br /> ` property? <br /> Yes M No 0471 <br /> L <br /> b.Within 250 feet? <br /> LYes Q No rM <br /> 1 . 14. Identify any surface waters within 1,000 feet.of the subject property <br /> Mokelumne River and several small ponds adjacent to the river. <br /> 15. a. Identify the potable water supply source: <br /> ` ®Public Water System M Other <br /> Private Well M None <br /> b. Is there observed evidence of a private well within 1,000 feet? <br /> Yes rM No Q several wells in the area <br /> 16. Identify the sewage disposal system: <br /> O Public Sewer System a Other <br /> rM On-site septic system O None <br /> ` 17. Are there any pits,ponds,or lagoons located on the property in connection with waste treatment or waste <br /> disposal? <br /> Yes Q No El <br /> 6. <br /> ` 18. a.Is there evidence that the subject property discharges waste water,other than storm water,directly into a <br /> ditch or stream on or adjacent to the property? <br /> l Yes Q No W1 <br /> L <br /> b.Any discharges observed within 200 feet? <br /> Yes O No <br />
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