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ARCHIVED REPORTS XR0012690
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ELEVENTH
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950
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2900 - Site Mitigation Program
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PR0505733
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ARCHIVED REPORTS XR0012690
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Entry Properties
Last modified
11/19/2024 10:19:10 AM
Creation date
9/3/2019 2:38:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012690
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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4 _ W, n <br /> r <br /> ®OAAD OF TFW®TEES SAN J®AQUIN' LOCAs. HEALTH DISTRICT OKAYING <br /> �1+�` "�Lrl,Vj"pets. 1801 boll Hazeffan Avonue�P.O.dos 2099 CMr of Lodi <br /> Fa'l . L VaFinv*A 6"'r. Bora J=quln Oevnty <br /> emt� 6lcekta ,CalKors�la 46201 "0ft"bVdV(flb mom" " <br /> otwa <br /> Ceram (309)408•®784 G'QCRY04 0 <br /> *W*16 M.D.Mo.K.,Dhtq f HOLM Oftw Cky 01 Wei l <br /> 044" KraUM d Treal <br /> Oaf 3acqutn County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GBOTHCHRICAL DATA AND <br /> SITE ASSESSMENT IN708MATION <br /> I, the undersigned owner and/or operator of the propertyEnd/or facility <br /> located at 950 West 11th Street, Tracy, California <br /> hereby authorize Western Deo - Engineers and/or Walton Engineer4ng. <br /> to release any and all anklytical results, geotechnical data and site <br /> ae�sesament information to the San Joaquin Local Health Dietrict as .soon <br /> '..s it is available and at the same time it is provided to me or try <br /> representative, <br /> aa <br /> AwrterfUperatar: Title': Director. Environmental <br /> r Address ox 1601 Phone: r■ 644-6784 <br /> 2-1601 <br /> !]ata: 4/29/88 _ <br /> f . <br /> 1 <br /> EN 08 05 UGT 13 <br />
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