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SU0004787 SSCRPT
Environmental Health - Public
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SU0004787 SSCRPT
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Last modified
5/7/2020 11:31:13 AM
Creation date
9/6/2019 11:10:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0004787
PE
2611
FACILITY_NAME
PA-0400074
STREET_NUMBER
26850
Direction
N
STREET_NAME
LOWER SACRAMENTO
STREET_TYPE
RD
City
GALT
APN
00503007
ENTERED_DATE
1/20/2005 12:00:00 AM
SITE_LOCATION
26850 N LOWER SACRAMENTO RD
RECEIVED_DATE
3/4/2004 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\L\LOWER SACRAMENTO\26850\PA-0400074\SU0004787\SSC RPT.PDF
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EHD - Public
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P.O. Box 576981 <br /> Fi M.J. Kloberdanz & Associates Modesto,California 95357-6981 <br /> Environmental Services Phone: (209)577-8186 <br /> Fax: (209)577-8158 <br /> Records Access Release <br /> To Whom It May Concern: <br /> i <br /> I (We), k d Ck Y-44L 64dk, the owner(s) of the property located at <br /> �O NAPN #i 00,e--,0.36-,0�- <br /> - give permission to M.J. Kloberdanz & Associates, to access this property as well as <br /> public records related to the property <br /> Signature <br /> F, FI-ederzc K CxLA- de.t <br /> [r-P LS <br /> r"1 / T!JCS L— <br /> F Print Name of Signature <br /> Phone Number of Deed Holder:;0 4-M-1 7A a.r a.) <br /> F 7 <br /> F! Instructions: <br /> The name of the owner must be the same name that appears on the Assessor's Record as the Deed <br /> Holder. if a company or corporation name has been used on the Deed then that name must be used <br /> above as the owners name. The Corporation or company letterhead should be used to photocopy <br /> P this form before completing. Some County Assessor's require an original signature(no photocopy <br /> or fax). This form should be mailed to MA.Klober4anz&Associates with a signature In an Ink color <br /> other than black. <br /> As available, and If pertinent, copies of the following must be provided to MJ. Kloberdanz & <br /> F Associates by the property owner prior to Job start: <br /> • Any previously Generated Appraisal or Environmental Assessment Reports <br /> • Site Contact Name <br /> • Site Contact Telephone Number <br /> + List of prior owners of the property,with the years they owned the property,and current phone <br /> FP1 <br /> numbers, <br /> • Authorization to view Assessor records of any larger parcel that the site may have been"spilt" <br /> from, <br /> • Copy of Business Plan for storage of chemicals filed with the County Environmental Health <br /> Department <br /> • Any other records that the owner may have that would be useful during this study that may be <br /> available <br /> ` E <br /> F: <br /> r <br />
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