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SITE INFORMATION AND CORRESPONDENCE_1985-1997
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0522692
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SITE INFORMATION AND CORRESPONDENCE_1985-1997
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Last modified
4/2/2020 2:47:19 PM
Creation date
4/2/2020 2:16:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
1985-1997
RECORD_ID
PR0522692
PE
2957
FACILITY_ID
FA0015465
FACILITY_NAME
FORMER MONTGOMERY WARDS AUTO SRV CTR
STREET_NUMBER
5400
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
10227008
CURRENT_STATUS
01
SITE_LOCATION
5400 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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tlDR.RD . F IRUSiEES SAN'f)AOUIN LOCAL HEALTH DIS TWT SERVING <br /> Jemee Culbeneon. Pies. City of Lodi <br /> Palrlcle E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joagi,lnCounty <br /> Anthonetle Van Spronsen City of Escolon <br /> Earl Plmenlel Stockton, California 95201 City or Manteca <br /> of <br /> Fern Bugbee 209/466-6781 Ripon <br /> Daniel L. Flores - City <br /> of of f Stotklon <br /> John D. Most. M.D. City ofTracy <br /> willlam J. wade Jog[ Khanna, M.D., M.P.M.. District Health Officer Sen Joaquin County <br /> Mary Anna Love Sen Joaquin County <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 /> located at 5400 PACIFIC AVENUE, STOCKTON, CA 95207 <br /> hereby authorize NORTH CAL CONSTRUCTION - <br /> to release any and all analytical results. geotechnical data and site <br /> dssessment information to the San Joaquin Local Health District as soon <br /> as it is available and at the same time it is provided to me or my <br /> representative. <br /> Ownef/Operato Title: <br /> Address Phone: <br /> PACI & ROBINHOOD ¢ CTZT N rA <br /> Date: 27 MAY 88 <br /> Ili 011 O5 , t1Gl 13 <br />
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