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SITE INFORMATION AND CORRESPONDENCE_FILE 2
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0001333
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SITE INFORMATION AND CORRESPONDENCE_FILE 2
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Last modified
1/29/2020 11:34:26 AM
Creation date
1/29/2020 11:16:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 2
RECORD_ID
PR0001333
PE
2950
FACILITY_ID
FA0004067
FACILITY_NAME
CHEVRON SERVICE STA 9-4183 (INACT)
STREET_NUMBER
236
Direction
N
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95242
APN
03710028
CURRENT_STATUS
02
SITE_LOCATION
236 N HAM LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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t January 22, 1992 <br /> Mr. Eric Trevene <br /> San Joaquin County Public Health Services <br /> Environmental Health Division <br /> 1601 East Hazelton Avenue <br /> Stockton, California 94621 42-0010 <br /> Subject: Application for Permit to perform Preliminary Soil <br /> Assessment <br /> Chevron Service Station No. 9-4183 <br /> 1236 North Ham Lane <br /> Lodi, California- <br /> Dear Mr Trevene <br /> I <br /> Enclosed is the information necessary to apply for a permit <br /> to conduct a reliminary site assessment at Chevron Service <br /> Station No. 9-4183, 236 North am 'Lane,�Lodi, California. <br /> The information provided is in accordance with your Site <br /> Mitigation Program; Guidelines for Work Plan and Report <br /> Submittal. The following materials are enclosed in this <br /> package: <br /> o Preliminary site assessment work plan including a <br /> health and safety plan with appropriate Material <br /> Safety Data Sheets <br /> o One check for the amodnt of $89.00 for the permit to <br /> drill soil borings. <br /> o One check in the amount for $159 .00 for environmental <br /> assessment review ( $53 . 00 per hour/ 3-hour minimum) <br /> o Application for permit filled out in triplicate <br /> o Site mitigation acknowledgment/request for services <br /> form <br /> Please call us if you have any questions regarding this <br /> project. <br /> Respectfully submitted, <br /> ALTON GEOSCIENCE <br /> Ted Moise <br /> Staff Geologist C E I V"E <br /> Enclosures R <br /> ,IAN 2 7 1992 <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br />
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