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FIELD DOCUMENTS_CASE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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TRACY
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2900 - Site Mitigation Program
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PR0505512
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FIELD DOCUMENTS_CASE 1
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Last modified
5/28/2020 12:43:08 PM
Creation date
5/28/2020 12:30:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
CASE 1
RECORD_ID
PR0505512
PE
2950
FACILITY_ID
FA0006827
FACILITY_NAME
BP/MOBIL SERVICE STATION
STREET_NUMBER
2375
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
APN
23207003
CURRENT_STATUS
02
SITE_LOCATION
2375 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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nonRU-oF IBUSIEes Qav JOAQUIN LOCAL HEALTH 0150RICT <br /> sarnea Culbertson, Pier. '"Clty of Lodi <br /> Halrlcla.F. Vannuccl,`5ec'r. = " 1601 East Hazelton Avenge :O <br /> Box 2009 ,; sa�+scaquinco"only <br /> Anihonette van Spronsen . .. .' ' Cltyol E'acalon <br /> Earl Pimenlel r " ' -StOGklon,,Call(orrtia 95201 ,; x i <br /> °' } `' r '•t ,Clty,diManteca <br /> •Fern 6aQt�ee i . <br /> 209/466-6781 C. ai FiiP on <br /> Daniel !_. f=loree - ;City of Stockton <br />` Bohn D. Mast, M.0.' v ;C#ty of Tracy <br /> William J::Wada 11:- -Jogs Khanna. M.O..'M.P.H., bletrlct'Health Officer $anJoaquln County' <br /> Mary Anna hove ' San Joaquin County l <br /> AUTHORIZATION TO RELEASE ANALYTICAL, RESULTS, GEOTECHNICAL DATA"'AND <br /> SITE ASSESSMENT INFORMATION <br /> x' I, the undersigned owner and/or operator.of the property.and/or facility <br /> located at 2375 :TRACY BLVD.,.' TRACY,. CA 9537.6 <br /> hereby authorize- KAPREALIAN ElgbINEERING, . 535 MAIN ST. , #309, MARTINEZ, CA94553 <br /> to release an and all analytical results. 415/228-1882 <br /> y y geotechnical data and site (MARDO KAPREALIAN) <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/0 era tor: MR., WILLIAM �70HNSON <br /> P MOBI OI CORP-1- T!tl e: _ENGINEER <br /> L Address P.O. BOX 127 Phone: 415/237-9227 <br /> RICHMOND:, CA 94807 <br /> Date: 5/30/86 ;.. <br /> , <br /> EH 08 05 <br />
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