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2900 - Site Mitigation Program
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PR0505070
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Last modified
1/17/2020 5:03:46 PM
Creation date
1/17/2020 3:27:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0505070
PE
2960
FACILITY_ID
FA0006510
FACILITY_NAME
CHEVRON PIPELINE
STREET_NUMBER
0
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
214-020-10
CURRENT_STATUS
01
SITE_LOCATION
GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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AN JOAQUIU COUNTY ;UBLIC HEALTH SERV <br /> ENVIRONMENTAL HEALTH OIVISIOU u <br /> P.O. SOX 388, 304 EAST WEBER AVENUI~ STOCKTON, CA M01_M Z <br /> (2091 aBB.3a2o <br /> Non-REFnNDA8t rem <br /> APPMATION It HM EY MADE TO TNQ CAN JOAM M COVHTY Pon A FEMW TO CONSTRUCT ANOIOR INSTALL THE%AAM OESCISSM.THM A LICATUM IQ MAO!IN COMMAP=WITH SIM <br /> "AO"COUNTY MILOPMENT TITLE.CHAPTER 0-1116.3 AND THE OTANCA OS OF CAN JOAOM COUNTY MMX HEALTH 4EIO 13.EPJWMOIA�A1 II'FALTH DMCON. <br /> CITY ✓ac <br /> �yy <br /> �� ,F7"�A'�L/LSZLNyrNa <br /> /Jar <br /> NAME ADDRESS M C,t�' <br /> r / <br /> CONTRACTOR �-Gv r-�a.�•v;K !✓.an1s�.•�1-w..�-s Lv< ADDRESS)00 0-'-btu S.rf%�...:sw CA 4Y(11 U=0601 yS�0 MOOR 1 143'f `l oa <br /> cuseoNTROCTON <br /> IJ;Ll La✓g�:,._. Ao �ts�C� q s 660 3D629( (9rr.) <br /> TYFE oP MYEIt/FtA . 13 NTW WCLL ❑ POKACL1L0111NT WE1L O MOwromm WELL/ ❑ oTxm <br /> ❑ n3STALLATnm ❑ VICSL svwrm RFPAcn ❑ CROSS4ommT mwAM ❑ WC=E)CTRACT=W U <br /> RrPE OF PUSRFT ❑Na:,C3Ur <br /> Rb N O. DElrN FUM.wr .PT. FXM WATM MKI O <br /> ❑ ow-coamma 1Ncu ❑ o6DFNvmcAL vwm a ❑ cm G m;l <br /> ❑ow rsTc. <br /> NCTpAO o us* Type Of WF14 CONSTRUCTION SPSCIRCAT1O" ,A <br /> ❑ OCDuvrmAL ❑opm eDTToM O1A.Of WE{L EXCAVATION 12" O:a OP CONDUCTOn CA== — O <br /> e OUL OF /'`❑ ooMCrCPavAE C3 mAVEt vAarsa TYPOF cnnNorsrTPvvxn <br /> ❑ PUSUCAllumsepAL ❑arry f DEPTH OP o11OLIT SEAL 3' CP2C=ATt" R <br /> ❑ AOOOATmuAO ❑oTm= CAMI T SEAL D WALLID BY GFwwT MANX;MAUI E <br /> 19&tomTofEPto r aswur Ii&AL FuMFm: [3 v. ❑N. CONCC.4TE PED¢arAL Err 6mLm C3Y. ❑N. 3 <br /> A6max orrH a a LOCKMO CHESTER eoxarow PWQ s <br /> F91OPO6©CONfTMAWITOXIDIRWT,q AIXTHOO: MUD RDTARY AIA ROTARY M-W-_Z�CAUSE OTH^o1 <br /> I HERESY CEPTTIFV THAT 1 NAVE"UPARED TMS APRX:ATION AND THAT TNT WOM WSL SS DONE M ACCORDANCE WITW SAN JOAOUSI COUNTY 0R0T3/AN!=M CTATE LAWO.AND MAEC AND <br /> PMULATLDNS OF THE am JOAO"CDUNTY. NOME OWNER OR UCEMRD AGWrS SIONATIAM CEITMWITO THE FOLLOWING:'i CL11TWV THAT IN TM MPUMMAMMIF OF TH*WOM FOC!vv"=m <br /> THIS PEFORIT IS ISEUED.1 CNALL NOT EMPLOY PERSONS MJKIECT TO NIONSMARM C0ftooteATWO LAWS 69 CAUIPOPMR " CONTRACTOWO I`tM O Oq CUM-COOMPACTWO=116ATUM com"re <br /> TM POLLDINOIC: 'I L'VTn9-r THAT M TNT PVFV40\AAMCE OF THE WOAR FOR WMCN TMS PIAMAIT M ISSUED.1 SKALL EMPLOY PONS QURJECT TO W04 Off o COmWC=7ION LAWO Of <br /> CAIDOfCOA.' THE AFaUCA/TT MW CALL 24 UMM M ADVANCE POR ALL RSGUWAD PUNWTIPOSS AT f2Sa1 Ai 142L DRAVJ=AT LDWVI AF=A FVMV=O.p <br /> Ovml X_ <br /> PLOT P\AO IDrw t.Sara)Sam. b <br /> 1. NAMES OF STREETC 011 ROADS N!/OQlT TO ON SOLRDom THE F1111009mY. 4. LOCATTDN OF HOUiB CMAW O xi OYOrvA an PRDPOL m <br /> S. OUTLINE OF THEE FROPVMY.OIV01tI DOWNSOM AND NORTH DSl CTKpL EXPANSION OF SEWA@3 OWPOCAL CYCTV=. <br /> 2. D!@HAIONED CtrrU F.t AND LOCATION G ALL METRO AND PROMSED S. LOCATION OF W010 WIT"M RADAR OF OX2 M ND=D FIFTY Fr. <br /> STRUCTULlR 10MLUOM COVOlO ARE"SUCH AS PATIOS.OMMAYS.AND WALItS. ON THE PFOMI TY OR ADJOWM PPWFMrY. <br /> :.. .y.. ........ ................ MAP ON BACK . .................... <br /> . . . . ,...... . <br /> i <br /> ............. ...... <br /> ................... <br /> ............. <br /> . ....................................... .................... <br /> of simoorr um omy <br /> Ap91�AM—o"d OT omo Arm <br /> Oia,A b....t*"of - O.I. I,, 0-o-o .,IDT One <br /> I Des. <br /> 7.... ;�579 7,1Z/ <br /> ACCOUNTWO GO&T: ASTM FAG <br /> PE COO® FEE MOO AMOUNT RIOIRTTTD CNetlW CAS" Igi'OVm SY DATE r"VAT140mCE PlemuzST ITIVOfCE <br /> i I I ► � <br /> '�I WOzi� wb'©6'8 X66 i—SZ—o <br />
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