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3500 - Local Oversight Program
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PR0545865
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Last modified
7/21/2020 10:04:37 AM
Creation date
7/21/2020 9:58:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
WORK PLANS
RECORD_ID
PR0545865
PE
3528
FACILITY_ID
FA0009358
FACILITY_NAME
COZAD TRAILER SALES LLC
STREET_NUMBER
4907
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710068
CURRENT_STATUS
02
SITE_LOCATION
4907 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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1 e� CY1tAefllOR, Pica. Cllyol Lodf;, . <br /> ar <br /> Patrlcirk E Vfannuccl, Secy. 160151 HazcliOn.AvenUq f C1• Bf7X 2D09 SanJoaqulRCounly,� <br /> City of Escalon:;. c, <br /> »Inonefte Van Spronsen j <br /> farlFfinen�el Slocklon, California 95201 City of Mani <br /> irn Bu t)ee <br /> city of <br /> ;,..♦.:1 209/466-6781 ,. .. <br /> iMet L lore City of Ssocktony <br /> ! CIty fit Tracy {{ a <br /> ohrf-D.Mris(. M.D. <br /> �P.�� <br /> ifllam`J.Wade Jog[ Khanna, h1.D., hd.P.H., Dlolric! Hoalth offlcof: SanJoaquloCountY;. ,.' <br /> San Joaquin County v. -I i <br /> °Mary`Anna Love a <br /> e�ri� i S <br />'.J•R II <br /> Y4 <br /> y ;tri y <br /> Fr♦ AUTH4RIZATIOH TO RELEASE ANALYTICAL. RESULTS, GEOTECHNICAL DATA AND <br /> t�=n#'SITE ASSESSMENT INFORMATIOfi <br />'s' th <br /> . V`je undersigned owner and/or operator o: the property and%or facility a <br /> located lat _4907 E. WATERLOO ROAD, STOCKTON, CA SN f <br /> he"re by! authorize . <br />{ `r tot 61ease any and all analytical cal res 1 ts, geotechnical , data; and i to ., <br /> 5 <br /> t,��; assessment information to the San Joaquin Local Health District as soon <br /> F+i 3as �t is 'avaiI ble and at the same time it is provided to me-; or my <br /> ;l xa <br /> � represktati ve. <br /> 4 ti: <br /> j �t <br /> _ - Titl( <br /> e <br /> Owrfe�-/Operator: -a- ''' <br />�F ` Address Phone:" 1� / <br /> gr <br />!`f4ri <br /> n Fir <br />,i Lc (�, ✓ 1 lik9�c 7; <br /> :s <br />,t.�..1 ! .... I ♦ ,giro-{ <br /> F til �,n 9 e <br /> r <br />.r a <br /> EH:08 45 UGT 13 i 4 <br /> C <br /> J <br />
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