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SU0005992 SSCRPT
Environmental Health - Public
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SU0005992 SSCRPT
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Entry Properties
Last modified
12/13/2019 11:08:27 AM
Creation date
9/6/2019 10:23:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0005992
PE
2622
FACILITY_NAME
PA-0600182
STREET_NUMBER
14101
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
LODI
Zip
95240
APN
06325027
ENTERED_DATE
4/12/2006 12:00:00 AM
SITE_LOCATION
14101 N JACK TONE RD
RECEIVED_DATE
4/11/2006 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\J\JACK TONE\14101\PA-0600182\SU0005992\SSC RPT.PDF
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EHD - Public
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r, Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: <br /> Property Location: 13737 N. Jack Tone Rd., Lodi, CA <br /> Page 4 <br /> r <br /> ENDORSEMENTS: <br /> Part 1 <br /> As the User of the Phase I Environmental Site Assessment being prepared for the property (or the duty <br /> authorized representative of such User), I have specific knowledge of the questions posed in Part 1 of <br /> this Questionnaire regarding the property, and hereby certify that to the best of my knowledge, <br /> ., information, and belief the information disclosed above is true and correct. <br /> User or Client's Signature Date <br /> ► Meda I e.r-w� M 6 w(e s <br /> User or Client's Name (please print) <br /> r <br /> n�W <br /> Title, Company <br /> ► <br /> 6. <br /> ► <br /> V <br /> V <br /> b. <br /> 6W Ifyou have any questions about this questionnaire,please contact Abby Rocco at(209)367-3701 ext.238. <br /> 6 <br />
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