My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SU0015311
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
E
>
ELEVENTH
>
3566
>
2600 - Land Use Program
>
PA-2200172
>
SU0015311
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/19/2024 10:20:00 AM
Creation date
12/19/2022 4:53:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0015311
PE
2632
FACILITY_NAME
PA-2200172
STREET_NUMBER
3566
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95304-
APN
23906018
ENTERED_DATE
12/19/2022 12:00:00 AM
SITE_LOCATION
3566 W ELEVENTH ST
RECEIVED_DATE
12/19/2022 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\lsauers
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
12
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
SAN 10 A Q U I N Environmental Health Department <br /> COUNTY <br /> PA2200172 <br /> HAZARDOUS MATERIALS DISCLOSURE SURVEY <br /> A separate survey form is required for each business name and/or address in San Joaquin County. <br /> Business Name: P&P PROPERTY DEVELOPMENT INC Telephone: (209)640-1000 <br /> Business Site Address: 3566 W. 11 th Street,Tracy, CA 95304 <br /> Mailing Address(if different from above): 25440 SOUTH SCHULTE ROAD TRACY,CA 95337 <br /> Business Owner(s)Name: P&P PROPERTY DEVELOPMENT INC Telephone: (209)640-1000 <br /> Business Owner Address: 25440 SOUTH SCHULTE ROAD TRACY,CA 95337 <br /> Nature of Business: TRUCKING STORAGE&MAINTENANCE Fire District: TRACY <br /> Q1. ❑Yes x No Does your business handle a hazardous material in any quantity at any one time in the year? <br /> See the definition of hazardous material on page 2 of this form. <br /> ❑Yes x No Does your business generate,treat,or store a hazardous waste in any quantity?(used oil,used <br /> antifreeze,waste solvent,etc.) <br /> If your answer is"No"to both questions in Q1,please print,sign,and date the bottom of this form and return to the address above. <br /> Q2. ❑Yes M No Does your business handle a hazardous material,or a mixture containing a hazardous material, <br /> in a quantity equal to or greater than 55 gallons, 500 pounds,or 200 cubic feet at any one time <br /> in the year? <br /> If"Yes", how long have you handled these materials at your business? <br /> If"Yes",check any of the following conditions that apply to your business: <br /> ❑A. The hazardous materials handled by this business are contained solely in a consumer product <br /> packaged for direct distribution to and use by the general public. <br /> ❑B. This business operates a farm for purposes of cultivating the soil, raising or harvesting an <br /> agricultural or horticultural commodity. <br /> Q3. ❑Yes X No Does your business handle an Acutely Hazardous Material? See definition on page 2. <br /> Q4. o Yes X No Is your business within 1,000 feet of the outer boundary of a school?(Grades K-12) <br /> I have read the information on this form and understand my requirements under Chapter 6.95 of the California Health and Safety <br /> Code(HSC). I understand that if I own a facility or property that is used by tenants, it is my responsibility to notify the tenants of the <br /> requirements which must be met prior to issuance of a Certificate of Occupancy or beginning of operations. I declare under the <br /> penalty of perjury that the information provided on this disclosure survey is true and accurate to the best of my knowledge. <br /> If you answered"Yes"to Question 2, please go online to cers.calepa.ca ctov to submit your hazardous materials information. <br /> Owner or Authorized Agent: <br /> Print Name: JA`SDE,EP SINGH Date: 06/23/2022 <br /> Signature: V71 Title: OWNER <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />
The URL can be used to link to this page
Your browser does not support the video tag.