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SITE HISTORY
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3500 - Local Oversight Program
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PR0545259
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SITE HISTORY
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Last modified
1/31/2020 3:55:34 PM
Creation date
1/31/2020 2:29:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0545259
PE
3528
FACILITY_ID
FA0004966
FACILITY_NAME
CHEVRON USA (INACT)
STREET_NUMBER
45
Direction
E
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
12707037
CURRENT_STATUS
02
SITE_LOCATION
45 E HARDING WAY
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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oar u�u�u/s SANK KOUINLOCALIi[ALTHDISII � <br /> ��m•, Cu14.1laon, P�•a• <br /> Palrlcla e• Vannuccd. Sac-y. SLAvmo <br /> Anlhonwt• Van Spronaan 1601 East Hazelton Avenue, P. O. 80!< 2009 San Joavuln county <br /> Cllr of Lodi <br /> E•d PMn•nt•l <br /> F414nvpboo Stockton.Catl(ornia 95201 City of Eacalon <br /> Daniel L Flores 209/4tifi 6781 city of Manl- <br /> Joho D. Mast, M.D. city of Ripon <br /> ace <br /> WlfilaJ.Wade Jopl Khans - Cltyof Stockton <br /> Mary Anne <br /> Anna Low 1 M.D, M.P.H.. Dhlrlcl Hadth O((1cw Gtyof Tucy <br /> San Joavuln County <br /> San Joavuln County <br /> AUTHORIZATION TO RELEASE ANALYTICAL .RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I, the undersigned 9 tam <br /> located at US er and/or operator of the Property and/or facility <br /> _€ Harrd(n <br /> hereby authorize EA Engineer ng, 'Scieand TechnologyaInc.� <br /> to.release any and all analytical results geotechnical data and site <br /> fnfoy <br /> •ssesslt>ent ulation to the San Joaquin Local Health District as soon- <br /> as 1t is available and at the same time it i <br /> representative. s provided to me or my <br /> Otm4/Operator: u`5&T- <br /> Address ud' kFitle: <br /> �iL^ �z►6ti . �`:--� Phone: v 2— <br /> Date:Date: <br /> EH nn nc Hr.T �z <br />
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