Laserfiche WebLink
SITE M i <br /> SAN JOAQUIN COUNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIVISION <br /> SITE INFORMATION ALTHER LE. GENCY RVMB, REG. 5 <br /> AGENCY ...TACT PAT LEARY <br /> ITE NAME LIBBEY OWENS FORD COMPANY <br /> PHONE 916-445-0270 <br /> APN # 195-270-62 <br /> DRESS 500 EAST LOU I SE AVENUE <br /> IF 9533 <br /> ITY LATHROP <br /> BILLING / RESPCNSISLE PARTY INFORMATION <br /> AME LIBBEY OWENS FORD COMPANY <br /> (LING ADDRESS 500 EAST LOUISE AVENUE <br /> LATHROP TATE <br /> CA IP 95330 <br /> ITY <br /> ONTACT NAME KIM REED. ACTING ENVIRONMENTAL COORDINATOR HONE 209/858-5151 <br /> PROPERTT OWNER/OPERATOR <br /> HONE 209/858-5151 <br /> AME LIBBEY OWENS FORD COMPANY <br /> DRESS 500 EAST LOU I SE AVENUE TATE CA IP 95330 <br /> ITY LATHROP <br /> CLIENT INFORMATION (IF DIFFERENT FROM OWNER/OPERATOR) <br /> NONE <br /> AME <br /> DRESS <br /> TATE IP <br /> ITY <br /> AUTHORIZATION TO RELEASE/BILLING ACKNOWLEDGEMENT <br /> 1, THE UNDERSIGNED OWNER, OPERATOR, CLIENT, OR AGENT OF SAME, OF THE PROPERTY LOCATED AT THE AOOVE SITE ADDRESS HERESY <br /> GEOTECHNICAL DATA AND/OR ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO <br /> AUTN00.12E THE RELEASE Of ANY AND ALL ANALYTICAL RESULTS, <br /> HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS <br /> SAN JOAOUIN COUNTY PUBLIC HEALTH SERVICES, ENVIRONMENTAL <br /> PROVIDED TO ME OR MY REPRESENTATIVE. <br /> ADDITIONALLY, 1, THE UNDERSIGNED OWNER, OPERATOR, CLIENT, OR AGENT OF SAME, AC <br /> KNWLEDGE THAT ALL 5179 ANO/OR PROJECT SPECIFIC <br /> PHS/EHD HOURLY CHARGES ASSOCIATED WITH THIS ACTIVITY.WILL,.BE BILLED TO THE PARTY IDENTIFIED ABOVE AS THE "RESPONSIBLE PARTY". <br /> APPLICANT'S NAME, TITLE, SIGNATURE/DATE <br /> AME Ms. KIM REED <br /> ATE 6/9/92 <br /> IGNATURE ,y.1, la, /-J <br /> - - RLE ACTING ENVIRONMENTAL COORDINATOR <br /> OMPANY LIBBEY OMENS FORD=COMPANY ._. .. .. <br /> (vo <br /> 89-007(IV)12/90BILFRMI2 - <br /> EH 29 01 <br />