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FIELD DOCUMENTS
Environmental Health - Public
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1665
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3500 - Local Oversight Program
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PR0545638
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Last modified
5/5/2020 11:18:58 AM
Creation date
5/5/2020 10:55:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545638
PE
3528
FACILITY_ID
FA0005998
FACILITY_NAME
UNION OIL SS#2859
STREET_NUMBER
1665
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
13702031
CURRENT_STATUS
02
SITE_LOCATION
1665 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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furl `_ i lee 19 00o oa—SACTo Qis—a `" 0034 P . 2 <br /> ;00 OF TRUSTIESSAN JOAQUIN LOCAL HEALTH DISTRICT SERVING •. <br /> ; r min.Mra <br /> i a&"LA s,raw FrW 1641 Easy Muahom Avenue, "�oq�uab �" <br /> e1r!W,rwe,1�$.oti. <br /> ��a ox Boor <br /> Fb�O0 $1ocM44%CalMornia!9241 i <br /> ntiw.n4l ' me <br /> .Of. iewskwqo j - (M)466.0741 "44 <br /> mmm <br /> �. of No" <br /> M#A M'',4 Abo ichmwm M.D.M-PA.&ASUI".dw nm..., (� <br /> s.Kan,wN teaey <br /> Sen Js{ C"my <br /> i <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL. DATA ANO <br /> SITE ASSESSMENT 1NFORNAT10H <br /> } <br /> 1 , the undersigned owner and/or operator of the Property and/or t¢Cility <br /> located at 1665 Pacifi venue -Stockton California <br /> hertby authorize Applied Geosystems <br /> to release any ane all analytical results. QeotechniCal data and site <br /> vi <br /> Asstssmtnt information to the San Joa _ <br /> as it is available and at the saate tfineitLisa rovided OisericL a$ soon <br /> � toeneor � <br /> ripr'tsentati ve. <br /> �''��r/�r'atoC: i�N4GAL Gor rat ion <br /> C'N r,,4L FALG <br /> v1 <br /> Jldd:ti; 2173 N. Callgvrnia hver�tta ,Title! (415 , <br /> Phone. <br /> Creek, CA <br /> Date: 6/1/88. Fps ay <br /> JUN <br /> ENVIROENThL.-HEALTH <br /> F MPS'%SIIRVICEB <br /> i <br /> r ± <br /> 5 ! <br /> IN 68 05 UGT 13 <br />
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