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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> Al Crow,Pres. Sen Joaquin County <br /> Earl Plmentel,Vice Pres. 1601 East Hazelton Avenue City of Manteca <br /> Tommy Joyce,Secy. Stockton, California 95205 City of Escalon <br /> James F.Culbertson City of Lodi <br /> John D.Mast,M.D. JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER City of Tracy <br /> Virginia Mathews City of Ripon <br /> Thomas Schubert D.V.M. ENVIRONMENTAL HEALTH DIVISION San Joaquin County <br /> Daphne Shaw (209) 468-3420 City of Stockton <br /> Harvey Williams,Ph.D. San Joaquin County <br /> AUTHOR I ZAT I Ohl TO RliASE <br /> ANALYTICAL RESULTS <br /> :rt GEOTECHNICAL DATA <br /> 4frF ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNER AND/OP. OPERATOR OF THE PROPERTY AND/OP, FACILITY <br /> LOCATED AT 14750 Harney Lane Lodi California <br /> (STREET ADDRESS) (CITY) <br /> HEREBY AUTHORIZE California Water Labs <br /> (LABORATORY or CONSOLTAfiff <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. <br /> BUSINESS NAME: Harney Lane Sanitary Landfill <br /> (IF APPLICABLE) <br /> OWNER/OPERATOR: Rudy Rodriguez, San Joaquin County Public Works <br /> ASE PRINT) (TITLE) <br /> (SIGNAIUREI <br /> ADDRESS: 1810 E. Hazelton Avenue <br /> (NAILING ADDRESS) <br /> Stockton, CA 95205 <br /> (CITY) (STATE) (ZIP) <br /> PHONE: ( 209 ) 468-3066 <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 468-34GO 468-3280 <br /> AIDS Information 468-3820 <br />