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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0506824
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
4/7/2020 3:10:54 PM
Creation date
4/7/2020 2:46:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0506824
PE
2960
FACILITY_ID
FA0007648
FACILITY_NAME
DDRW - SHARPES
STREET_NUMBER
850
Direction
E
STREET_NAME
ROTH
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19802001
CURRENT_STATUS
01
SITE_LOCATION
850 E ROTH RD BLDG S-108
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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Feb.10 '96 9:53 0000 B&F DRILLING CO. TEL 916-631-6097 P. 2 <br /> sERYI E RMEST its OD bb.bv amd S/Y3/�J <br /> 1'AC(Li1Y Ib 11 kticptb Ib g [Rv4)rE P , <br /> -- <br /> fAOiim NAM W etLLilir. Paerr <br /> S17E.AObREss .{n•� �y` '{ /�ti <br /> Cl TY ,�—,—a !'1 Are CA TIP•,_•_,„,,,,, <br /> GNNER/0?ERA7CR lA S /►'t �•• BILLING PART.' y /; <br /> )NA � __ _— _ PHONE AL :t 9 <br /> AOORESS '`J 7t — PHONE OR•C�_� <br /> CITY SPATE ZIP <br /> pnrl�H W Uce Applfeatien 0 <br /> L wQ4 Met Ldce[tm <br /> ^smn, <br /> dW.RACT'OR hndfor <br /> sentCE Arcilm Btum -4 <br /> QUA +�• / / y� ///� q f ___ PNLfIE A7 � v <br /> NA)L)N&MDREIIBCd�,�,^7�6 b �r�/jIL C L V,CJ`�L� �Q FAX <br /> 0 <br /> CITY <br /> STATO TIP. <br /> NILLINO ACMIKINARIGEWNT: 1, the uMeroignod ougee, Operator or agent of same, acknowledge that N%t Oita ord'for ptoJ t speofftd <br /> PW/SD,'hourly eemrooF associatod, with this feeility or motivity will to bitted to the party idmRtfff*d 0e the PhLIM PARTY on ' <br /> Iiif 6fa for". . <br /> t &IM oarklfy that 1have prepured tMo applicJtlon and that the work to be perfonMd will IM do Jb in accordance wl h OU SAN <br /> JCAWIN:l:iXNTY.Ordinence codes and scanderde, Spate W�d- al to a. <br /> APMICANTrS FIgNATU [� '�.'x� - <br /> Title <br /> AyINORIFATi9% TO 101,641! 10"NA11ON: In additnon to the above, „hen ahplicable, 1, the owner, gxrotor Or agent of aim , of <br /> the promrty loomled at the show alt* addreiS hereby authorize the ralcoao of any and all rest!te, goottehnieaL clot and.w <br /> onAraliilentai%olte easommom t tnfor"atlon to SAN JOAUl11N CUM;Y P11a1.iC IIEA!_TN SERVICES .ENVIAONNORTAL MALTN OlVliltNl M am as ' <br /> It is Owl{WAe, arM at the own time It is provided to ,1e or my representattve. <br /> Nat ire sof ServlCe RayNaet: —_ Serivits Code <br /> i <br /> MtTuned.to _ Cilpiiryea <br /> 'Dara' wylee complaud ,____f_.; �' Further Action Required! Y / a PaOBkkN ELEMENT <br /> /ae Anldunt Amount Pald Date of Payment Payment Type Aeeeipt N' ',shack X Ra ey <br /> RENS !_l� IiWV f�, / ACT f ,/_ LIMI CLK <br /> �0'd L6©BLG_93ZEt Ol I+��I� Wlit+0:E0 'S66T T-� <br />
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