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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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" a <br /> BILL OF LADING <br /> 3909 Park Road,Suite D <br /> VVIRONMENTAL SERVICES Benicia,CA 94510 <br /> GROUP (877) 748-3040c <br /> ,Western Region <br /> DELIVERY DATE JOB 466 <br /> SHIPPER/CUSTOMER POINT OF CONTACT <br /> b tt � <br /> \DDRESS a PHONE# <br /> :ITY,STATE,ZIP <br /> .qtr-Z ,;.,. <br /> :ARRIERpp/TRANSPORTER <br /> ,q 7 PHONE# <br /> � :_..�`�2'Ci`�L�at"~'it�.�` ���X33'7n-..:.,_ �'%��`i.is 1 Z;a� � � i"v�f�•i.•��...}l�t),-'. <br /> :ONSIGNEE/FACILITY POINT OF CONTACT <br /> ADDRESS PHONE# <br /> 'ITY,SSTATE,ZIP - <br /> 3 <br /> r <br /> ipecial Handling Instruction and Additional Information: <br /> ax kFY"2, -i G'X h : 2„ r� � -..�t ONJO (30<7. M-U ,�-CJ t ...tU; 9r'M uR0''e tTr�F�1 n WTi;:I4:. MIAMI P{ Pui <br /> �v!'ik #''� 2 �cc.''il _ ''ill .ii-.;.- ; �nt:��.�1P �a€'t.6:"?�1,e�.T� #r#egz.�• <br /> "4 1, <br /> i <br /> nacards Provided YES NO Emergency Phone#(877)748-3040 <br /> 'HIPPER'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 /> narked,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 /> HIPPER)PRINT OR TYPE NAME/,, SIGNATURE Mona+ oav YEAR <br /> 'ER/TRANSPORTER)PRINT OR TYPE NAME SIGNATURE MONTH Cwv vEntt <br /> mow. <br /> X <br /> a <br /> JEE/FACILITY)PRINT OR TYPE NAME SIGNATUREF`j unv_ YEua <br /> }fffJ ,tfF s <br /> Jt-RV 6/04 <br /> SHIPPER <br />
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