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SU0006926 SSCRPT
Environmental Health - Public
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2600 - Land Use Program
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SU0006926 SSCRPT
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Last modified
5/7/2020 11:32:49 AM
Creation date
9/9/2019 9:07:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0006926
PE
2622
FACILITY_NAME
PA-0800027
STREET_NUMBER
11981
Direction
S
STREET_NAME
ROBERTS
STREET_TYPE
RD
City
STOCKTON
APN
19115003
ENTERED_DATE
1/25/2008 12:00:00 AM
SITE_LOCATION
11981 S ROBERTS RD
RECEIVED_DATE
1/25/2008 12:00:00 AM
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\ROBERTS\11981\PA-0800027\SU0006926\SSC RPT.PDF
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EHD - Public
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Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E06057A <br /> Property Location: 11981 S. Roberts Road, Stockton, CA 95206 <br /> Page 4 <br /> ENDORSEMENTS: <br /> Part 1 <br /> As the User of the Phase I Environmental Site Assessment being prepared for the property (or the duly <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 /> Use or Client's Signature to <br /> (I)esa , J-�>,77z) <br /> User or Q'ient's Name (please print) <br /> Title, Company <br /> If you have any questions about this questionnaire,please contact Abby Racco at(209)367-3701 ext. 238. <br />
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