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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br />Al Crow, Pres. <br />-P+ <br />Sen Joaquin County <br />Ead Plmentel, Vice Pres, <br />1601 East Hezellon Avenue <br />City of Manteca <br />Tommy Joyce, Secy. <br />Stockton, California 95205 <br />City of Escaion <br />James F. Culbertson <br />City of Lodi <br />John 0. Mast. M.D. <br />JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER <br />City of Tracy <br />Virginia Mathews <br />City of Ripon <br />Thomas Schubert D.V.M. <br />ENVIRONMENTAL HEALTH DIVISION <br />San Joaquin County <br />Daphne Shaw <br />( 203 ) 468-3420 <br />City of Stockton <br />Harvey Williams, Ph.D. <br />Sen Joaquin County <br />E <br />A U T H O R I Z A T I O N T C3 FcE L E A E3[=- <br />-ee- ANALYTICAL RESULTS <br />+E GEOTECHNICAL DATA <br />-w ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br />I, THE UNDERSIGNED OWNER AND/OR OPERATOR. OF THE PROPERTY AND/OP, FACILITY <br />LOCATED AT 1856 N. BROADWAY <br />CALIFORNIA 95205 <br />iREEI ADD SS) (CITY) <br />HEREBY AUTHORIZE EOUOIA ANALYTICAL LABORATORY <br />(1ABOAVORY or CORSDUAND <br />TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OR <br />ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOADUIN LOCAL HEALTH <br />DISTRICT AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br />TO ME OR MY REPRESENTATIVE. <br />BUSINESS NAME: GOTELLI LIFT TRUCK SERVICE <br />(IT APPLICABLE) <br />OWNER/OPERATOR: WARD GOTELLI <br />ADDRESS: 1856 N. BROADWAY <br />(ARTURO ADDRESS) <br />(CITY) (SIAfE) (EPR) <br />PHONE: ( 2u9 ) 4b5 3b09 <br />DATE: L8 FEBRUARY, 1991 <br />EH 23 041 Revised 1/89 <br />Administration Clinical Servicos Environmental Health <br />468-3400 468-3630 468-3420 <br />Air Pollution Community Servlces Laboratory <br />460-3470 468.3820 468-3460 <br />AIDS Information 468-3820 <br />Public Hoaith Nursing <br />468-3860 <br />WIC <br />468-3200 <br />