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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MADISON
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3500 - Local Oversight Program
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PR0544428
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SITE HISTORY
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Last modified
5/6/2019 5:05:34 PM
Creation date
5/6/2019 5:00:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0544428
PE
3528
FACILITY_ID
FA0004581
FACILITY_NAME
CHASE CHEVROLET*
STREET_NUMBER
423
Direction
N
STREET_NAME
MADISON
STREET_TYPE
ST
City
STOCKTON
Zip
95203
CURRENT_STATUS
02
SITE_LOCATION
423 N MADISON ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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04.0+0 Or TAui1FF5 c� Pd (-A HrAt.,i Ia �i�i P,IG* ItAV?ffc <br /> SAN JOAQUI LU , t. rk <br /> 160"09 t:vlbarlfom, Ffla. ')Iy of Lod, <br /> atuleu L, vannwael, Ssc'r. t"^ ao•au+nCOW64y <br /> Aoftnelts Van 3peons0r► .1601 East Hatclio11 Avenua, P. 0. Boz 7069 Cttyofe,ea{on <br /> tall Ilnsaniel Stockton, Calllornsa 95201 ally of manieca <br /> A*fA auo00a City of Aloon <br /> 0001161 L. Flofaa 2129/4615-8781 City <br /> of stocklon <br /> Jahn 0, m6st, M'0- City of?roar <br /> William J. Wad• Jssgi Khanna, M.O., M.P.M., Qtalrict stalln offlem Son Joaquin Comer <br /> Mary Anna Love San Joaquin Gountr <br /> 1 <br /> I <br /> i <br /> AUTHORIZATION TO RUCASE ANALYTICAL RESENTS, G€OTECHMICAL DATA ANO <br /> SITE ASSESSMENT iNFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> loCated at 423 N. Madison Street, Stockton, CA 95202 <br /> hereby authorize ter'Nork Corporation <br /> to release any and all analytical results, geotechnical data and site l <br /> asstS%ment information to the San Joaquin Local health diStriCt 30� S00n <br /> as it is available and at the same time it is provided to Erse or mY <br /> representative. <br /> ` Attorney <br /> Dwne /Operator: aC Title: <br /> Address 1.818 Grand Canall Blvd. ; Stec Con. C 207 phone: 2fi9, ala-182 <br /> Date: 2/24Ifl9 <br /> Cu CA f1f •j? Z ? <br />
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