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86-409
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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86-409
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Entry Properties
Last modified
9/7/2019 12:10:09 AM
Creation date
12/2/2017 1:06:03 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
86-409
STREET_NUMBER
9110
STREET_NAME
THORNTON
STREET_TYPE
RD
City
STOCKTON
SITE_LOCATION
9110 THORNTON RD
RECEIVED_DATE
4/29/86
P_LOCATION
SOUTHLAND CORP
Supplemental fields
FilePath
\MIGRATIONS\T\THORNTON\9110\86-409.PDF
QuestysFileName
86-409
QuestysRecordID
1946545
QuestysRecordType
12
Tags
EHD - Public
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kJOA <br /> srne o ul ll3on, Pro <br /> Ls SAN JOAOUIN LOCAL HEALTH DISTRICT SERVING <br /> �=Jamea CulGertson, f re's <br /> Palflcla E. VannuCCl. Secy City of Lodl <br /> Anlhonette Van Spruntien 1601 East Hazelton Avenu©, P. O. Box 2009 San Joaquin County <br /> Earl Plmnntel Slocklon, California 95201 City Of Escalon <br /> Fern Bugbou !! City of ManloCa <br /> Daniel L. Flores I 209/466-6781 City of Ripon <br /> John D. Mast, M.D. CltyofStockton <br /> William J. Wade i Jogl Khanna, M.D., M.P.H, District Health officer T—" a . ,, City of Tracy <br /> Mary Anna Lova I I ' ! 1, ,5 �,1Q�$ uInCounty <br /> fl � :7 i:J�4... L5 _r1b� In County <br /> ENVI# i ---;-:TAL HLALTH <br /> F E1tf;cif i"/SER'JfCES <br /> AUTHORIZATION' TO RELEASE ANALYT;C <br /> u AL RESULTS, GEOTECHNICAL DATA A <br /> SITE ASSESSME'`NT INFORMATION ! <br /> 1 . the undersl gned owner and/or operator of the property and/or facility <br /> located at 9110 Thornton Road, Stockton , CA 95209 j <br /> hereby authorize GroundWater Technology, 5047 Clayton Road , Concord, CA 94521 <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 /> as it is available and at the same time it is provided to me or my <br /> representative``. <br /> I <br /> CONTACT PERSON: DAVE LEW <br /> Owner/Operator: The Southland Corporation Title: Gasoline Manalger <br /> Address 5820 Stoneridge Mall Road , Suite 310 phone: (415)463-2711 <br /> Pleasanton, CA 94566 <br /> ud Le. II&Y- �. 1986�_�� <br /> l <br /> I <br /> f <br /> fI <br /> i <br /> l <br /> r <br /> .i <br /> I <br /> II <br /> I <br /> EH 08 -05 I� <br />
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