Laserfiche WebLink
BOARD OF TRUSTEES SA74 JOAQUIN LOCAL HEALTH DISTKICT SERVING <br /> AI Crow,Pres. San Joaquin County <br /> Ead Plmeniel,Vice Prea 1601 East Hazelton Avenue llrQQ City of Manteca <br /> Tommy Joyce,Sec'y. Stockton, California 95205 /N /9 u City of Escaton <br /> James F.Culbertson ry'f 5 City of Lodi <br /> John 0.Mae%M.D. JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER Jr /A City of Tracy <br /> Virginia Mathews f)Ui City of Ripon <br /> Thomas Schubert D.V.M. ENVIRONMENTAL HEALTH DIVISION J. San Joaquin County <br /> Daphne Show (209) 468-3421) City of Stockton <br /> Harvey Williams,Ph.D. San Joaquin County <br /> AUTHA7FZ I ZAT I EJN TO FZEL-EASE <br /> ++ ANALYTICAL RESULTS <br /> x GEOTECHNICAL DATA <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OP, FACILITY <br /> LOCATED AT _ 1146 Ente_rgri se, St�CA <br /> (ATREEI ADDRESS) (CITY) <br /> HEREBY AUTHORQE Canonie Environmental , Stockton,- (209) 983-1340. <br /> -----_-----11ABDRAlDRK er-6DNiDt7`A1fiJ <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OR <br /> ENVIP.ONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAQUIN LOCAL HEALTH <br /> DISTRICT AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE. �o �+ <br /> BUSINESS NAME: /�/ R � 4p 4,8ft co I <br /> (If ARRLICABLE) <br /> OWNER,/OPERATOR: U) & p <br /> U S !NI) (TITLE) <br /> (SISNATUREJ <br /> ADDRESS: 1/S/6 F/J E, Q fit S <br /> (RAILING ADDRESS) <br /> S 75-c a, cad{. 9s�o y <br /> (CITY) (STATE) (111) <br /> PHONE: ('109) <br /> DATE: 3-3Q•- 90 <br /> EH 23 041 Revised 1/89 <br /> Administration Clinical Services Environmental Health Public Health Nursing <br /> 468-3400 468-3830 468-3420 468.3860 <br /> Air Pollution Community Services Laboratory WIC <br /> 468-3470 468-3820 466-3460 468-3280 <br /> AIDS Information 468-3820 <br />