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ARCHIVED REPORTS_XR0012598
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MOFFAT
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229
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3500 - Local Oversight Program
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PR0545566
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ARCHIVED REPORTS_XR0012598
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Entry Properties
Last modified
10/10/2020 11:48:13 PM
Creation date
3/17/2020 4:52:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012598
RECORD_ID
PR0545566
PE
3528
FACILITY_ID
FA0005479
FACILITY_NAME
MANTECA BEAN CO
STREET_NUMBER
229
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
229 MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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f <br /> c,iao'of`IAusIIts 'SAN J0A0L1IN LOCAL. HE ALT Ii DISI HILT Stnv,t4a <br /> - , y uCltyolton <br /> M.41 .U1(allon, F'rr� SanJoayuin <br /> stacls E. Vannucc , Lacy 160 [ar! IicucEian fvcno, ('. O, Eox ?UaCI1y o,Ejcrion <br /> nth v,n spionsnn tGCtlGl, California 95201 CISy ofMany ■ <br /> rrl <br /> Elly of Ripon <br /> rrn 2(Y1/4GG-6781 <br /> City 41.51pCklOn <br /> Inial L. Flores cllrpllta.'y <br /> 'tin t), Mast. M,I), <br /> ilium J. V:a9a JaCl Khanna. M.D„ M,P.H., 015WO Neallh Ur""r SinJoaqulncounty <br /> wanJoaqu[nGounty <br /> ary Anna Luya <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASS£SStiENT (NFO,1'VkTIO:( <br /> I, the undersigned owner and/or operator of the property anti/or facility <br /> located at Cr,-,,it & tiilcesell Avenue !'anteca, C.A 95336 <br /> hereby authorize SCS Fnpi-rw.ets <br /> to release any and all analytical results, geotechnical data and site <br /> e ` ;sment informtion 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 /> C},rne�/O erator: / j r <br /> Title:Mice President ('peraticx�s <br /> Address C.)ldan Grain ! z CO- Phone: <br /> (415)357-E1400 <br /> 1111 _ 139Th A«Iue, Srn le,mdrO, CA 94578 <br /> Date: riI 22 1987 <br /> a <br /> it wl o5 <br />
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