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COMPLIANCE INFO_2004-2005
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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2575
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2300 - Underground Storage Tank Program
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PR0231070
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COMPLIANCE INFO_2004-2005
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Last modified
1/30/2023 2:30:02 PM
Creation date
6/3/2020 9:43:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2004-2005
RECORD_ID
PR0231070
PE
2351
FACILITY_ID
FA0006439
FACILITY_NAME
COUNTRY CLUB MOBIL CIRCLE K
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231070_2575 COUNTRY CLUB_2004-2005.tif
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EHD - Public
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n <br /> 023 ILL OF LADING <br /> 3909 Park Road, Suite D' <br /> -- <br /> w>RONMffiOUP Benicia, CA 94510 <br /> sExvfcEs (877) 748-3040 <br /> Western Region <br /> DELIVERY DATE JOBf> -` s <br /> SHIPPER/CUSTOMER POINT OF CONTACT <br /> kDDRESS PHONE# <br /> 21:1"Y.13 e..1�'+t f � -tzar:.; <br /> ;ITY,STATE,ZIP <br /> ;ARRIER/TRANSPORTER PHONE# <br /> i}�•irtT:� °Y; e'�'"4x�:��'L'`'��5�'t�-2z-1;�3�v' k. _' d.r3 }�°.2�j" ,�.£I?i <br /> :ONSIGNEE/FACILITY POINT OF CONTACT <br /> kDDRESS PHONE# <br /> ,ITY,STATE,ZIP <br /> MT ^i°I� .tl,_i .a,'•._; <br /> i <br /> special Handling Instruction and Additional Information: <br /> 'k Sa iT7�� $�T Sx y �IxS sof i7 f�s- 4 Wh� Yf.Q �iiSE4 VAST'F i0ld9 Mi5 0 48Uk1131.1 6XV Jntp'? P'YOTEtTI& CWT!.RA- M.RS ey ?$1*136F. <br /> placards Provided YES NO Emergency Phone#(877) 748-3040 <br /> CHIPPER'S CERTIFICATION:i hereby declared that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, <br /> marked,and labeled,and are in all respects in proPer condition for transport by highway,vessel;and rail according to applicable international and national government regulations. <br /> SHIPPER)PRINT OR TYPE NAME -.SIGNATURE - - MoNm ovfv Yenrt <br /> (.- f` <br /> CARRIER/TRANSPORTER)PRINT OR TYPE NAME SIGNATURE MONrtc ova . YEM <br /> ( f X <br /> CONS4GNEEXAC11"PRINT OR TYPE NAME St E -vow <br /> { i t f 'l I `F� ` �• <br /> � 4 <br /> omii#PSC401-RV 604 <br /> SHIPPER <br />
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