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2900 - Site Mitigation Program
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PR0009056
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
10/3/2019 9:07:45 AM
Creation date
10/3/2019 8:43:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
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 3 214 233 036' •GLLFS CORP. G2 <br /> BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson,Pru. City of Lodi <br /> Mary Anne Love,Vice Pres, 1601 East Hazelton Avenue, P.O. Box 2009 Sit'Joaquin County <br /> Patricia E.Vannuccl,See'y. 6rn Joaquin County <br /> Tommy Joyce Stockton, Calilornla 96201 City of Escaion <br /> Earl Plmentel City of Manteca <br /> virglnla Mathews (209)466.6781 City of Ripon <br /> Daniel L Flores i city of Stockton <br /> John D.Mail,M.D. Joy]Khania,M.D.,M.P.N.,District Health Mor City of Tracy <br /> Gene S.Kraham San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DA ['A AND <br /> SITE ASSESSMENT INFORMATION <br /> l <br /> I , the undersigned owner and/or operator of the property and or fac ' lity <br /> located at 'Lodi Overhead Door Company, 1220 East Victor Rd . , Lodi , �Californ.fa <br /> hereby authorize Remediation Services , Inc . of Pleasanton, C <br /> to release any and all analytical results , geotechnical ctatla and sijte <br /> assessment information to the San Joaquin Local health Distr ct as goon <br /> as it is available and at the same time it is provided to me or my <br /> representative. <br /> Owner/Operator: ( � Title . a <br /> Address Dallas Co ration Phone: - , 11 <br /> reeway, •e . <br /> Dallas , Texas 75380-9046 <br /> Date: 5/22/89 <br /> l <br /> P:H 23 041 3/86 <br /> II <br /> I <br />
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