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WORK PLANS_FILE 2
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0503361
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WORK PLANS_FILE 2
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Last modified
5/19/2020 9:06:46 AM
Creation date
5/19/2020 8:52:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
FileName_PostFix
FILE 2
RECORD_ID
PR0503361
PE
2960
FACILITY_ID
FA0005798
FACILITY_NAME
SOUTHWEST HIDE COMPANY
STREET_NUMBER
11651
STREET_NAME
PALM
STREET_TYPE
LN
City
RIPON
Zip
95366
APN
22809005
CURRENT_STATUS
01
SITE_LOCATION
11651 PALM LN
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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1 <br /> BOARD OF 1RUST EES SAN JO, .dUIN LOCAL HEALTH DISTRIC't SERVINo <br /> Jame3 Culbertson, Pres. <br /> Pelrlcle E. Vennuccl, SecCity of Lodiy. San Joa ul <br /> Anlhonetle Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 q n County <br /> Earl Pimento[ Stockton, Callfornia 95201 City of Escalon <br /> Fern Bupbee City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of StocktonCity of Tracy <br /> William J. Wade Jog[ Khanna, M.D., M.P.H., Dfatrict Health Offlcer San Joaquin County <br /> Mary Anne 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 11651 Palm Lan Ripon California <br /> hereby authorize Dana Means , Manager <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 /> Dana Means�--)1-1 <br /> Owned/Operator: _ Southwest Hide Company r Title: Manager <br /> Address P.O. Box 2083 Phone: (209)599-4251 <br /> Manteca, CA 95336 <br /> Date: 5 September 1986 <br /> i <br /> EH 08 05 UGT 13 <br />
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