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SITE INFORMATION AND CORRESPONDENCE_FILE 1
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545028
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SITE INFORMATION AND CORRESPONDENCE_FILE 1
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Last modified
12/6/2019 2:59:14 PM
Creation date
12/6/2019 2:48:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 1
RECORD_ID
PR0545028
PE
3528
FACILITY_ID
FA0003919
FACILITY_NAME
VAN DE POL ENTERPRISES
STREET_NUMBER
5491
STREET_NAME
F
STREET_TYPE
ST
City
BANTA
Zip
95304
CURRENT_STATUS
02
SITE_LOCATION
5491 F ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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From:Wayne Woodward 707-374-5677 To:Nuel Henderson Date:12!2/2004 Time;1:33:28 PM Page 1 of 1 <br /> Well Drillers Authorization Letter <br /> Site Name: <br /> I <br /> Site Address: 5491 F St <br /> City: Banta, CA <br /> Well Driller Woodward Drilling Co., Inc <br /> Drillers Address P.O. Box 336 <br /> City, State, Zip Rio Vista, CA 94571 <br /> Drillers Phone# (707) 374 4300 <br /> C-57 License# 710079 Exp. Date 7/31/2005 <br /> For the sole purpose of procuring permits for drilling, well construction, and well <br /> destruction's, I hereby designate the following entities to act as our authorized <br /> representative. <br /> Name: Cheryl Martin <br /> I <br /> Company: Apex Envirotech <br /> Address: 11244 Pyrites Way <br /> City, State,Zip Gold River, CA <br /> I understand that as the applicant for permits,.I am responsible for compliance with <br /> all provisions of the permits. I also understand that upon written notification, that I <br /> may rescind this Authorization. <br /> I <br /> Signed: <br /> I <br /> ...... . . . ... . <br /> Printed: Wayne G. Woodward <br /> i <br /> Date: . December 2, 2004 <br /> I <br />
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