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SITE INFORMATION AND CORRESPONDENCE CASE 1
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0505733
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SITE INFORMATION AND CORRESPONDENCE CASE 1
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Last modified
11/19/2024 10:19:51 AM
Creation date
9/3/2019 2:30:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
CASE 1
RECORD_ID
PR0505733
PE
2950
FACILITY_ID
FA0006970
FACILITY_NAME
TOSCO #787
STREET_NUMBER
950
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23406002
CURRENT_STATUS
02
SITE_LOCATION
950 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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� t <br /> TWATM SAW., ,AQUIK LOM HEALTH DIS&T eE <br /> +terP <br /> Csl ss„ M# <br /> 16014"16waNN Aw",P.O.80 200! tM, <br /> t+tel► � �C��1�ia(0101 � p <br /> 4�!MUMU Cor M Mow" , <br /> v1r Mew (M)Odd-dTil « <br /> CUM 1.Pbm Cow <br /> J60 Now%MA:.M.l4N»Dom"No 06M "01Tom► <br /> Q�f.KtMll�i wa�pufn GwMy <br /> F <br /> AUTHORIZATION TO RRL$A8S ANALYTICAL RRSULTS,'.aSOTSCHNICAI, DATA AND <br /> .SITE A88SS8USNT INFORMATION <br /> r <br /> ;I , the undersigned owner and/or operator of the property and/or laaility: ' <br /> looatod at 950 West lith 8trs*t, Tracy, Celilornia <br /> hereby authorize Western Geo Engineers and/or Walton Engineering. ,! <br /> to, release any .aud all anklytical results, geotechnical data and site ' <br /> assessment intormation. to` the San Joaquin Local. Health District as soon <br /> as it it available and at the same time it is provided to aye or my ' <br /> representative. <br /> owaarfoperator: <br /> ,.�d:'1. Title: Dixettort ironms�ttsl <br /> Address P.A. Eox 1606 Phone: �` r' bp4-Gy84 <br /> AYnYr _ nt 93Q32-1601 <br /> 4/39/819 <br /> } <br />• BH 08 06 UOT 13 <br />
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