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SU0007141 SSCRPT
Environmental Health - Public
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SU0007141 SSCRPT
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Last modified
5/7/2020 11:32:55 AM
Creation date
9/9/2019 11:00:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0007141
PE
2611
FACILITY_NAME
PA-0800134
STREET_NUMBER
722
Direction
S
STREET_NAME
WALKER
STREET_TYPE
LN
City
STOCKTON
APN
15911025
ENTERED_DATE
4/22/2008 12:00:00 AM
SITE_LOCATION
722 S WALKER LN
RECEIVED_DATE
4/22/2008 12:00:00 AM
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\W\WALKER\722\PA-0800134\SU0007141\SSC RPT.PDF
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EHD - Public
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�- Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E07021A <br /> Property Location: 748 f& 808 S. Walker, 5205 E. Main, Stockton, CA <br /> Page 11 of 11 <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 �o <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 /> ! cq� W� 3 — I—d7 <br /> Owner or Key Site M per's Signature Date <br /> Rob-cn�r CG Re-S-e- <br /> Owner or Key Site Managers Name (please print) <br /> bitt len -om—p Mah h <br /> LT , Comp ny <br /> L <br /> L lfyou have any questions about this questionnaire,please contact Abby Racco at(209)367-3701 est.238. <br /> L '404 <br />
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