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SITE HISTORY
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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TENTH
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503
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3500 - Local Oversight Program
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PR0545725
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SITE HISTORY
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Last modified
6/3/2020 1:41:38 PM
Creation date
6/3/2020 1:30:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0545725
PE
3528
FACILITY_ID
FA0003519
FACILITY_NAME
SJ CO AG COMMISSIONER/TRACY*
STREET_NUMBER
503
Direction
E
STREET_NAME
TENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
503 E TENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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SAN JOAQUINd LOCnL HEALTH TRICT <br /> "Ory l& C. low,vac. 1'r.., SERVING <br /> iG41 E..I f{aiellon Avenue, P.O. Box 2009 <br /> F.uticl• E. Y■nnuccl, 6.c'r. CNy of L041' <br /> To-"r"y JoyC• <br /> San Joaquin County <br /> Ea.1 F'"*M.{ Stockton, Cailiornla 95201 San Joaquin C*vniy <br /> "7"A Matlr.w. CNy Vl E.CktOn <br /> D-44 L Eb... (209) 466-67a 1 CKY of Ment.ca <br /> 01V 04 n1po-M <br /> Joh D.Most, M.D. 01Y d 5lackron <br /> nrn. 6.Kraham Jog(Kh+^^ti M,r)�M.t.H,"br"fSaatth otnc.# <br /> CRy e(Tracy r <br /> ran Joaqurn County (` <br /> AUTf{OItILATION TO RELEASE ANALYTICAL RESULTS, GEOTECE{!{ICAL DATA ANDSITE ASSESSMENT INFORMATION{ � <br /> i <br /> Ir the undersigned owner and/or operator of ttte property and/or <br /> located at facility <br /> Of <br /> San Joa. uzn County locations <br /> r hereby auttzorize Canonie" Engineering; Inc. <br /> to release any ar'd ,all. analytical results , <br /> geotechnical data and site <br /> assessment information to ttic Sari Joaquin Local Health District; as so <br /> as it is availableand at ttie same time it is provided to me on <br /> or my <br /> repres-entatzve. <br /> SaJoaquirCoun�y Government Buildings <br /> O <br /> CUII <br /> wner/Operator : D nni.s Marciasini <br /> 1722 E. Scotts 1lvenue Tz tie : Assistant Director <br /> — f'lrc�rrc: : <br /> —S- --� _ <br /> Date : --i Llay 2 p er. 19 8 8 <br /> ENVIHOMEN" AL HEI;LTFI <br /> FERitisiT/SERVICES. <br /> i <br />{ <br /> Fit <br /> 6 f <br />
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