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ARCHIVED REPORTS_XR0012576
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545483
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ARCHIVED REPORTS_XR0012576
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Entry Properties
Last modified
3/10/2020 9:04:49 PM
Creation date
3/10/2020 10:57:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012576
RECORD_ID
PR0545483
PE
3528
FACILITY_ID
FA0005939
FACILITY_NAME
MANTECA MULTIMODAL STATION
STREET_NUMBER
260
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
22102024
CURRENT_STATUS
02
SITE_LOCATION
260 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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s <br /> C" <br /> �M�1 �17f7 . <br /> r <br /> SERVING <br /> soano of tRUS1EES SAN JOAOUIN LOCAL HEALTH DISTRICT City of Lodi <br /> Linea CulRar'ison. Pres, San Jaaquln County <br /> 3 City of Escaion <br /> ,Irate t. V.nnuccl, sac y 1601 East Hazelton Avenuo, P.O. Box 2 City of Maniacs <br /> qr':--Z6II4 Van SDronson Stockton,California 95201 City of Ripon <br /> Ey Menlo, <br /> 2t79l466 6781 City at Stockton <br /> "on flupose <br /> City of Tracy <br /> Intel t. Flores <br /> John D.Most, M.17, Jopl Khanna, M.o.. M.P.H.,t)latrlcl µealtn Officer San Joaquin County <br /> SanJaaqulnCaunly <br /> William J.Wada <br /> ary knna tor$ <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I, the undersigned owner and/or operator of the property and/or facility <br /> 260 E. Main Street, Manteca, CA <br /> located at Stockton, CA 983-1340 <br /> hereby authorize _ Canflnte Environmental , <br /> to release any and all analytical results, <br /> echn'calDistrictdata dasTsonn <br /> ,sessment information to the San Joaquin Local <br /> Health as it is available and at the same time it is provided to me or my <br /> representative. <br /> _ Title: Owner ��cG <br /> owner/operator: phone: rnTnj wR6-063 <br /> Address 1 <br /> San Francisco, CA 94134 <br /> Date: <br /> CIO no nr. llrT 1 Z <br />
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