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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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7675
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3500 - Local Oversight Program
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PR0544802
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SITE HISTORY
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Last modified
11/19/2024 10:19:50 AM
Creation date
9/4/2019 11:31:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0544802
PE
3528
FACILITY_ID
FA0005153
FACILITY_NAME
FAYETTE MANUFACTURING CORP
STREET_NUMBER
7675
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
25014012
CURRENT_STATUS
02
SITE_LOCATION
7675 W ELEVENTH ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Cfttul fvoff► JrnST <br /> :-y � f 1(•2�1�1 <br /> BOARD OF iRusTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> City of Lodl <br /> James Culbertson, Pres. Sen Joaquln County <br /> Patricia E. vannuccl. Secy 1601 East Hazelton Avenue, P. 0. Box 2009 City of Escalon <br /> Anthonette van Spronsen City of Manteca <br /> Earl Plmentel Stockton, California 95201 <br /> City of Ripon <br /> Fern Buobee 209/466--6781 City of Stockton <br /> Daniel L. Flores City of Tracy <br /> John D. Mast, M.O. San Joaquin County <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer <br /> San Joaquin County <br /> Mary Anna Love <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION , <br /> I , the undersigned nWner and/or operator of the property and/or facility <br /> located at XZ� <br /> hereby authorize '� r <br /> to release any and all analytical results, gent nical data and site <br /> assessment information 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 /> 11/1 Title: <br /> Owner/Operat ' � <br /> p e: - C� <br /> Address <br /> Date: , At, <br /> rz� des re) C4 F0 �" <br />
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