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COMPLIANCE INFO_1986-2006
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231331
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COMPLIANCE INFO_1986-2006
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Last modified
6/20/2023 9:32:19 AM
Creation date
6/3/2020 9:43:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1986-2006
RECORD_ID
PR0231331
PE
2351
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231331_975 S FAIRMONT_1986-2006.tif
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EHD - Public
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4. <br />James Culbertson. Pces. <br />' <br />PalrlVa'E. Vannuccl, Sec'y. <br />Anthonalte Van Spron3en <br />Earl Pirnanief <br />Fern 8uQt)ea <br />Danial L. Floras <br />John D; Mast, M.D. <br />William *J. Wade <br />Mary Anna Love <br />1601 Ot Hazelton. Avenue, P. 0. Box 2009 <br />Stockton, California 952011 <br />209/466-6781 <br />Jogl Khanna, M.D., M.P.H., District Hoalth Officer <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />1, 1 the undersigned owner and/or operator of the property and/or facility <br />located at 975 S. FAIRMONT AVE., LODI. CA <br />hereby authorize CALIFORNIA WATER LABS <br />to release any and all analytical results, geotechnical data and site <br />dssessment information to the. San Joaquin Local Health District as soon <br />as it is available and at the same ti'me it is prbvided to me or my <br />representative. <br />.Owned/Operator: LODI MEMORIAL HOSPITAL. Title: <br />Address 975 S. FAIRMONT AVE. Phone. 334-3411 <br />LOD'I _ CA <br />Date: 4/21/88 <br />I <br />EH 08 05 UGT 13 <br />City of Lodi <br />San Joaquin County <br />City of Escalon <br />City of Manteca <br />City of Ripon <br />City of Stockton <br />City of Tracy <br />San Joaquin County <br />San Joaquin County <br />
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