Laserfiche WebLink
W42 <br />TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br />James Culbertson, Pres. SERVING <br />Patricia E. Vannuccl, Secy Clly of Lodi <br />Anthonette Van Spronson 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br />Earl Plmentel Stockton, CalllOrnia 85201 CITY of Escaton <br />Fern BupDee City of Manteca <br />Daniel L. Flores 209/466-6781 City of Ripon <br />John D. Mast, M.D. City of Stockton <br />William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer City of Tracy <br />Mary Anna Love San Joaquin County <br />San Joaquin County <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AN6�`<'y� yo <br />SITE ASSESSMENT INFORMATION <br />�lbF ' <br />I, the undersigned owner and/ r opprator Af the pro arty and/or facility <br />located at t �` <br />hereby authorize S in j -T a lv1/I <br />to release any and all analytical results,lgeotechnical 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.tt p �P tal '4 j <br />Owner/Operator: V ( Title: Q[k Z(7C <br />Address , Phone: jQ4 <br />Date <br />EH 08 05 UGT 13 <br />