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ARCHIVED REPORTS
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS
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Last modified
5/5/2020 3:06:11 PM
Creation date
5/5/2020 2:11:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
RECORD_ID
PR0545641
PE
3528
FACILITY_ID
FA0002480
FACILITY_NAME
SHOP N GO 3
STREET_NUMBER
4511
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11023011
CURRENT_STATUS
02
SITE_LOCATION
4511 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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r- Z <br /> PUBLIC HEALTH SERVICES <br /> G <br /> SAN JOAQUIN COUNTY <br /> tA: a <br /> JOGI KHANNA hi.D.,M.P.H. <br /> Healrh Officer " c•.• �P <br /> P.O. Boas 2009 • (1601 East Hazelton Avenue) a Stockton, California 95201 <br /> (209) 46&3400 <br /> .BAR 41991 <br /> (� <br /> FlyHARLEEN KAUR �J <br /> 4511 PACIFIC AVENUE <br /> STOCKTON CA 95207 <br /> RE: ARCO Mini Market SITE CODE: 1216 <br /> 4511 Pacific Avenue CONTRACTOR #: 39000 <br /> Stockton, CA 95207 <br /> The attached "Notice of Reimbursement" is official notification that your site has been assigned to the San <br /> Joaquin County Public Health Services, Environmental Health Division's Local UST Oversight Program <br /> for oversight of assessment and clean up activities at contaminated underground tank sites. <br /> Fees for review activities and inspections associated with contaminated site assessment activities will not be <br /> billed by this office. The State Water Resource Control Board (SWRCB) will invoice you directly for <br /> activities performed under the auspices of the Local UST Oversight Program. The goal of the site <br /> evaluation performed by Public Health Services Environmental Health Division (PHS/EHD) is to certify <br /> closures of underground tank leakage sites. Closure certification occurs only after mitigation activities are <br /> completed. <br /> A Letter of Acknowledgment is enclosed for your completion and return. Your acknowledgment of the <br /> placement of your site into the Local UST Oversight Program as stated above is respectfully requested. In <br /> addition, the individual or individuals authorizing the continued investigation shall provide identification <br /> with respect to their title of authority. <br /> In addition, this Acknowledgment indicates that the "Regional Board Staff Recommendations For Initial <br /> Evaluation and Investigation of Underground Tanks" and "Appendix A" reporting format and the LUFT <br /> Manual will be utilized as guidance documents in the preparation of work pians and/or reports. <br /> If you have any questions or there are any corrections in the responsible party information, contact Diane <br /> Hinson, REHS, at (209)468-3452. <br /> Jogi Khanna, M.D., M.P.H. <br /> ZEnvironmeZntal <br /> a, REHS, Program Manager <br /> ealth Division <br /> Enc. <br /> c: SWRCB, Underground Storage Tank Section <br /> c: CRWQCB, Central Valley Region <br /> c: Arthur L. and C. E. Wyatt, 656 Rosemarie Lane, Stockton, CA 95207 <br /> Division of San Joaquin County Health Care Services <br /> i" <br />
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