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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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1267
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2900 - Site Mitigation Program
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PR0505602
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
6/20/2019 2:46:40 PM
Creation date
6/20/2019 1:39:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0505602
PE
2950
FACILITY_ID
FA0006891
FACILITY_NAME
BANK OF THE WEST
STREET_NUMBER
1267
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
11304217
CURRENT_STATUS
02
SITE_LOCATION
1267 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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SITE MITIGATION PROGRAM <br /> BILLING LETTER Off' ACKNOWLEDGEMENT= <br /> TO: SAN- aOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION (PHS-EHD) <br /> 445 N. SAN JOAQUIN ST. <br /> P. O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> FROM: Bank of the West <br /> (property owner name) <br /> 1450 Treat Boulevard <br /> (owner mailing address) <br /> Walnut Creek, California 94596 <br /> (city, state , ZIP) <br /> RE• 1267 Country Club Boulevard, Stockton <br /> (site address) <br /> I (We) declare that the assessment activity being performed at the <br /> above referenced site is being conducted with my (our) knowledge and <br /> approval. Furthermore, I (we) acknowledge that payment of PHS-EHD <br /> charges will become my(our) responsibility in the event said <br /> charges are not paid by the client and/or operator identified on <br /> the attached "General Program File. " <br /> (510) 943-8367 <br /> (signature and title) (phone number) <br /> �iG✓l <br /> 7-0t <br /> ! r <br /> (date) <br /> LC\BILACKN. FRM <br />
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