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REMOVAL_1988
EnvironmentalHealth
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PR0501782
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REMOVAL_1988
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Entry Properties
Last modified
4/1/2020 11:52:43 AM
Creation date
11/2/2018 6:23:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
1988
RECORD_ID
PR0501782
PE
2381
FACILITY_ID
FA0005220
FACILITY_NAME
CHEVRON #9-4054
STREET_NUMBER
2103
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12308029
CURRENT_STATUS
02
SITE_LOCATION
2103 COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\C\COUNTRY CLUB\2103\PR0501782\REMOVAL 1988.PDF
QuestysFileName
REMOVAL 1988
QuestysRecordDate
11/7/2012 8:00:00 AM
QuestysRecordID
113134
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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tVAw ur Int SIEEr <br />Jsnaa cut-ponson. P"'. <br />â–ºsltr.N E. v.nnuod. S.c'y. <br />AAII* .atls van 2p omen <br />Earl rtmettlal <br />Fort, au9bw <br />DaMM L Flores <br />John D. Mut. M.O. <br />VnIttaat J. We& <br />Mary Anna Lew <br />SAN OAQUIN LOCAL HEALTH OISTF <br />1601 Easl Hazellon Avenue, P. O. Box 2009 <br />Stockton. Callfornla 95201 <br />209/468-8781 <br />J0911 Klunna. M.D., M.P.N., Dfatrke Health CX1ker <br />T <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />I. the undersigned owner and/or operator of the property and/or facility <br />located at z1o3 country club, Stockton <br />hereby authorize Sequoia Lab 2549 Middletown Rd Redwood city,CA <br />to release any and all analytical results. geotechnical data and site <br />assessment inforItlation to the San Joaquin Local Health District as soon <br />as it is available and at the same time it is provided to me or my <br />representative. <br />OwneF;Oper4jtor. <br />Ron Beffa" Title:_Engineer <br />Address Chevron USA Inc. <br />Phone: 415-842-9520 <br />P Box 5004 San Ramon CA 94583-0804 <br />Date: September 16 1988 <br />EH 08 OS UGT 13 <br />SERVING <br />Gtr of Lodi <br />San Joaquin County <br />City of E scslon <br />city of Manteca <br />city of Ripon <br />Coy e/ Stockton <br />City of Tracy <br />San Joaquin county <br />San Joaquin County <br />
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