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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545174
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
1/13/2020 2:36:32 PM
Creation date
1/13/2020 2:13:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545174
PE
3528
FACILITY_ID
FA0004965
FACILITY_NAME
CHEVRON USA (INACT)
STREET_NUMBER
3246
Direction
E
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
14341001
CURRENT_STATUS
02
SITE_LOCATION
3246 E FREMONT ST
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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SA <br /> cuttLenson, r�.,_ N .kOUIN LOCAL N ALT1-i 01S M <br /> I <br /> alcfa E. vannuccl. seer. S S(fiv�itt) i.' <br /> 7 <br /> n1Aonatte Yen S . Cur of todt ,. <br /> p�onaen 1601 East Hazt!Iton Avenua. P. O. Box 2009 S`an Joadutn County <br /> ed Plinente{ <br /> .rRLAuptyee Stockioq,Callfornia 95201 Gtr Of Etc&ion <br /> anal[.. Ftorea C{ty of Matti' <br /> )An 0. Most. M.Q. , 2a9/46s�781 City of <br /> Ripon <br /> 'altar J.wade City of Stockton <br /> E3 a '7 <br /> ary Anna i ova JoQ{t�t►a�nar {+t-0..'t+t.P_H., x]Odd ROOM Oracer CRY of Tracy . <br /> 4 Stn Joaquin County <br /> San Joaqutn County <br /> I <br /> E <br /> AUTHORIZATION TO RELEASE ANALYTICAL. RESULTS. GEOTECHNICAL FIAT , <br /> SITE ASSESSMENT INFO RMATtOH A ANa <br /> i <br /> W <br /> Ie the undersigned <br /> owner and/or operator .of lthe 6mperty and/or facility <br /> located at 36 E. Fver►,a„fi . Ave. J + <br /> hereby ' I. _ - <br /> authorize Engineezing, 'Science, and Technology, Inc_ . <br /> to,r�elease any and all, analytical results <br /> geotechnical data and site <br /> Asscssment information, <br /> to the San :Ioaquin Locall Health District as soon- <br /> as it is available and; at the same tfitae it is provided to me or tiiy <br /> ti E. <br /> representative. <br /> OKn40perato r: <br /> AddressGh - �f\ [� G!; itle: 3 <br /> Phone: 3 <br /> 04 t e: <br /> i <br /> I; <br /> r <br /> l f l q <br />
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