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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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yi <br /> BILL OF LADING <br /> 3909 Park Road, Suite D <br /> NVIROANENTAL SERVICES Benicia,,CA 94510 <br /> r.ROUP (877) 748-3040 ad i riq } }µe _ . 123'1t 3 a <br /> West rn•'Region <br /> DELIVERY DATE JOB#I <br /> ;HIPPER/CUSTOMER POINT OF CONTACT <br /> M:)MESS 9y� PHONE# <br /> :ITY,STATE,ZIP <br /> �ARRiER/TRANSPORTER . PHONE# <br /> i—W�1) Yms_ IR+: SOR AML7W <br /> 11.40:,i <br /> CONSIGNEE/FACILITY POINT OF CONTACT <br /> kDDRESS PHONE# <br /> ._. A.l.a e .E1k't Bwoa <br /> -ITY,STATE,ZIP <br /> III iiiiiiii IN MISSION <br /> ;!r;a j. PTmcs r": <br /> 3 <br /> J <br /> ipecial Handling Instruction and Additional Information: <br /> 'els i. f•. q- T t , +f T'' r. ; c ,w <br /> �� - :cam �?�� �u ��S,� :,��,i� 4�C=Ii= �,�'-rt P�� �N�u��;! -• _ �r:h. �..r_n�_ �2i�`�;��i�i°� "tt��rlg�;. ts����� �ry dui~ <br /> 'lacards Provided YES NO Emergency Phone#(877)7 <br /> ;NIPPER'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 <br /> '- ��',�, WONFH DAYS YEAR <br /> ,CARRIER/TRANSPORTER),PRINT OR TYPE NRME SIGNATURE Man» DAY vEAR <br /> ;CONSIGNEE/FACILITY)PRINT QR T.YPEidAt,V1E f-SIG .TUBE a+ YEAA/ <br /> K f - X t.. l i` t.• I f , ! fes,. <br /> % <br /> %rm#PSC-201-RV 6/04 ` <br /> SHIPPER <br />
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