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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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14900
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2900 - Site Mitigation Program
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PR0009023
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
11/19/2024 3:47:37 PM
Creation date
5/7/2020 3:57:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0009023
PE
2960
FACILITY_ID
FA0004091
FACILITY_NAME
TOWER PARK MARINA
STREET_NUMBER
14900
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95242
APN
05503015
CURRENT_STATUS
02
SITE_LOCATION
14900 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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F BOARD OF TRUSTEES SAf'OAOUIN LOCAL HEALTH DISTF SERVING <br /> Jamas Crbarlwe,Pros. City of loth <br /> ad <br /> Mary Anne t.oM vice Prete ast 1601 EHazelton Avenue,P.O.Box 2009 4� Sar.Joaa,by Cermet <br /> Paha E vannueel.Sae'y. <br /> Too � <br /> Stockton,,,Caolomia 95201 s'" p�O 'a h <br /> Eacalon <br /> Vi VW@ Mathew* (209)466-6781 city of Ma^deca <br /> carr a Ripon <br /> Darrel t_Flores city of seocklon <br /> Jam D.Mast M.D. Jori Khanna.M.D-M.P.M. Dasbld Hoam Otroc r <br /> City of Tracy <br /> Gent S.Kraham San Joaquin Count <br /> h <br /> { <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION I <br /> i <br /> I . the undersigned owner and/or operator of the properly and/or facility <br /> located at Tower Park Marina, 14900 W. Hwy. 12, Terminous, CA 95240 { <br /> hereby authorize ERT <br /> to release any and all analytical results, geotechnical data and site <br /> assessment information to the San Joaquin Local Health District as soon <br /> i <br /> as it is available and at the same time it is provided to me or my <br /> representative. `�. <br /> Signed: <br /> Owner/Operator: Public Storage, Inc. Title: Donald Bunce, Agent for <br /> Address 11824 Dublin Blvd. Phone: (415) 828-4805 Qwner <br /> I Dublin, CA 94583 i <br /> Date: June 20, 1988 <br /> r <br /> EH 08 05 UGT 13 <br />
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