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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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v.® <br /> BILL. OF LADING <br /> 3909 Park Road, Suite D <br /> 4VIRONMENTAL SERVICES <br /> Benicia, CA 94510 <br /> GROUP (877) 748-3040 <br /> Western Region <br /> DELIVERY DATE JOB#. <br /> SHIPPER/CUSTOMER POINT OF CONTACT <br /> ADDRESS PHONE# <br /> '[TY,STATE,ZIP <br /> 'ARRIER/TRANSPORTER PHONE# <br /> 'ONSIGNEE/FACIUTY POINT OF CONTACT <br /> kDDRESS PHONE# <br /> ;ITY,STATE,ZIP <br /> on wErl <br /> Pit!F* w X: w- <br /> ;pecial <br /> Handling Instruction and Additional Information: <br /> ? ...T&TT <br /> ti . 4 <br /> . a <br /> 'lacards Provided YES NO Emergency Phone#(877) 748-3040 <br /> SHIPPER'S CERTIFICATION:i hereby declared that the contents of fhis consignment are it*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 raN according to applicable international and national government regulations. <br /> SHIPPER)PRINT OR TYPE NAME _ --SIGNATURE -'' -''`, MONTH DAY YEAR <br /> CARRIERITRANSPORTER)PRINT OR TYPENAME SIGNATURE MotJni DAY YEAR <br /> -A <br /> CONSIGNEE/FAC"PRINT OR TYPE NAME SIGNATURI= <br /> MONTH. onY, Yt as <br /> t <br /> X <br /> orm#PSC-201-RV 6/04 _ ? <br /> CARRIER <br />
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