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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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4 <br /> 4 <br /> BILL OF LADING <br /> 3909 Park Road, Suite D <br /> Benicia, CA 94510 <br /> WMON.Kffi VTAL SERVICES <br /> GROUP (877) 748-3040 ;_�>_. _ -<. -r <br /> Western Region <br /> DELIVERY DATE JOB <br /> ;HIPPER/CUSTOMER POINT OF CONTACT <br /> ADDRESS PHONE# <br /> ;ITY,STATE,ZIP <br /> 'ARRIER/TRANSPORTER PHONE# <br /> i h..;i+a: 4" �'�1 `1 73it+.+�4_A.S.Z r IMCYN .1w.' x-401�.��..5-a"l.�.-._$` <br /> :ONSIGNEE/FACILITY POINT OF CONTACT <br /> ADDRESS PHONE# <br /> ::r Actt't S. fllkulst s;'f Rn ais <br /> -ITY,STATE,ZIP <br /> f. <br /> 3 <br /> 'pecial Handling Instruction and Additional Information: <br /> Ss .�s nlL k i A-6I?.PW!': 9EA» PROM,, ?1M77r'TMq 'MM—RIVil 5C:����NCT $`a5?� sy' <br /> UT 0 :394: c4B-`14:')3 i1s'I 5'K-2i R.a <br /> 'lacards Provided YES NO Emergency Phone#LS-M 748-3040 <br /> iHIPPER'S CERTIFICATION:i hereby declared that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, <br /> narked,and labeled,and are in all respects in proper condition for transport by highway,vessel,and rail according to applicable international and national government regulations. <br /> SHIPPER)PRINT OR TYPE NAME SIGNATURE i' s; MONTH DAY YEAR <br /> J <br /> CARRIERITRANSPORTER)PRINT OR TYPS NAME SIGNATURE MONTH DAY YEAR <br /> { _ X <br /> CON.$IGNF EE/F LITY)PRINT OR TYP NAME SIGNATURE _ DAY YE�w <br /> - 1 _ <br /> #'PSC-201-RV Mill <br /> SHIPPER <br />
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