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FIELD DOCUMENTS_FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0542014
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FIELD DOCUMENTS_FILE 1
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Last modified
1/16/2020 5:31:35 PM
Creation date
1/16/2020 3:56:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0542014
PE
2960
FACILITY_ID
FA0023306
FACILITY_NAME
LARRYS AUTO REPAIR
STREET_NUMBER
308
Direction
N
STREET_NAME
GRANT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
308 N GRANT ST
P_LOCATION
01
QC Status
Approved
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EHD - Public
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BOARb OF vptus1EEs SAN*„JAQUIN LOCAL HEALTH DIST,,,:T SERVING <br /> Jamas Culbertson. Pres. City of Lodi <br /> Patrkia E. Vaonuccl. Sac'y. 1601 East Hazelton Avenue, P. O. Box 2009 San JoaavinCounty <br /> Anthonelte Ven Spronsen <br /> City of Escalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern Bupbee 209/466 6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John 0. Mast, M.D. City of Tracy <br /> William J. Wada Jopl Khanna, M.D., M.P.N., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I, the undersigned owner and/or operator of the property and/or facility <br /> located at 825 E. IvJIER ST. ST0=N CA <br /> hereby authorize F.G.L. NELSIN LABORATORY of STOCKTON <br /> to release any and all analytical results, geotechnical data and site <br /> assessment information to the San Joaquin Local Health District as soon <br /> as it is available and at the same time it is provided to me or my <br /> representative. <br /> Owner/Operator: �, ��. Title: <br /> Address p_0. BOX 100308 STOC[ZI'ON Ca. Phone: 9,11-6161 <br /> Date: 13 SEPT 1988 <br /> iii 08 OS UGT 13 r <br />
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