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2900 - Site Mitigation Program
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PR0009056
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Last modified
10/3/2019 9:04:34 AM
Creation date
10/3/2019 8:43:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0009056
PE
2960
FACILITY_ID
FA0004059
FACILITY_NAME
LODI DOOR & METAL CO
STREET_NUMBER
1220
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
1220 VICTOR RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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'89 05/22 1�•2 $ 214 23.3 0367 0ALLRS CORP. 02 <br /> BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVINGJames Culbertson,Pru. <br /> Mary Anna Lova,vice Pres, 1601 East Hazelton Avenue, P.O. Box 2009 CIor Loin <br /> Palricls E.Vannuccl,Secy. SPn Joaquin <br /> Courtly <br /> Tommy Joyce $IOCkIDIt, California 95201 SLn Joaquin County <br /> Earl Plmental City of Eacalon <br /> Virginia Mathew# (209)466-6781City of Manteca <br /> Daniel L.Flores City of Ripon <br /> John D.Mast,M.D. 1City of Stockton <br /> Jogi Khania,M.D.,M.P.H.,District Health 011kar :�;, City of Tracy <br /> Gene S.Kreham <br /> Spin Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECIINICAL DA 'A AND <br /> SITE ASSESSMENT INFORMATION <br /> i <br /> the undArsigned owner and/or Operator of the property and or facility <br /> located at Lodi Overhead Door Company, 1220 East Victor Rd. , Lodi , lCalifornia <br /> hereby authorize Remediation Services, Inc . of Pleasanton, C <br /> to release any and all analytical results , geotechnical data and site <br /> assessment information to the San Joaquin Local health District as goon <br /> Its it is available and at the same time it is provided to me or my <br /> representative , <br /> Owner/Operator: <br /> Title: _ <br /> Address Dallas Co `ration <br /> Yeeway, •e . Phone: - 11 <br /> Dallas , Texas 75380-9046 ^� <br /> Date: 5/22/89 <br /> 1:11 23 041 3/80 <br /> I <br /> 1?1l <br />
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