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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,'a - - - <br /> BILL OF LADING <br /> 3909 Park Road, Suite D. <br /> VVIRONMEN'TAL SERVICES Benicia, CA 94510 <br /> GROUP (877)748-3040 <br /> Western Region <br /> DELIVERY DATE JOB# _ <br /> SHIPPER/CUSTOMER POINT OF CONTACT <br /> ADD _ PHONE <br /> '9 6"t T ti.rrtsro <br /> WE; <br /> u._ w......._ <br /> 'ARRIER TRANSPORTER PHONE# <br /> � .� � °r' �1a3 :Sf",r rovn'1:;. - "'a,.as`'• 'f::f`: 'St" <br /> :ONSfGNEE/FACILITY _ EPHONE# <br /> TA°CT <br /> : tip TW"- <br /> IDDRESS d <br /> :ITY,STATE,ZIP <br /> all al <br /> 3 <br /> >peciai Handling instruction and Additional Information: _ <br /> dd '�1'�id�r3€-$� _ �F�i t.a-��ii l�•"- ���Ma <bcJ ;` � �{��: ;.�tl �l� lf_, _ a h�.( .2 }Y PP y � r.rg;a�zs ;fl',Tiila � y' {�.� ;7 n '�- iy se, <br /> _ u3?i.. k _ ri.. � c' �.,..i' r�`t.�} 4L? ::�k �v�s3 �:;1. _4L� t•_:,,�,,. ;�£�. �.�.:a�'���.� �:,+,�"..�4. <br /> P K NW 1,- :i it111-i']?i, FAMIRUP'IP A;Vcl.`f�°— tom <br /> 4acards Provided YES NO Emergency Phone#(877)748-3040 <br /> SHIPPER'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 interQational and national government regulons. <br /> SHIPPER)PRINT OR TYPE NAME. SIGNATURE . r ti r'; onv rEw <br /> 'ARRIER/TRANSPORTER)PRINT OR TYPE NAWE SIGNATUR>;'� f naormi DAY yens <br /> x <br /> 'SIGNEE/FACIUTY)PRINT OR TYPE NAME SIGNATURE MONTH- DA�Yq YEM <br /> r' l <br /> X ,: <br /> 'SC-201-RV 6/04 <br /> SHIPPER <br />
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