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SU0006532 SSCRPT
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SU0006532 SSCRPT
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Last modified
5/7/2020 11:32:29 AM
Creation date
9/9/2019 9:09:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0006532
PE
2622
FACILITY_NAME
PA-0700176
STREET_NUMBER
21301
Direction
N
STREET_NAME
ROND
STREET_TYPE
RD
City
LODI
APN
01105007
ENTERED_DATE
4/24/2007 12:00:00 AM
SITE_LOCATION
21301 N ROND RD
RECEIVED_DATE
4/24/2007 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\ROND\21301\PA-0700176\SU0006532\SSC RPT.PDF
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EHD - Public
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Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E07025A <br /> Property Location: 21301 N. Rond Rd <br /> Page 4 of 11 <br /> ENDORSEMENTS: <br /> Part 1 <br /> As the User of the Phase I Environmental Site Assessment being prepared for the property (or the duly <br /> authorized representative of such User), I have specific knowledge of the questions posed in Part 1 of <br /> this Questionnaire regarding the property, and hereby certify that to the best of my knowledge, <br /> information, and belief the information disclosed above is true and correct. <br /> (Aisgr'or nt's ignature Date <br /> User or Clients Name (please print) <br /> Q nc"/- <br /> Title, Company <br /> .r <br /> If you have any questions about this questionnaire,please contact Tina Cheney at(209)367-3701 ext. 233. <br />
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