Laserfiche WebLink
BOARD OF TRUSTEES SAw,.JOAQUIN LOCAL HEALTH DIS).XT SERVING <br /> James Culbertson,Pros. City of Lodi <br /> Mary Anna Lova,Vice Pres. 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> Patricia E.Vannuccl,Sec'y. San Joaquin County <br /> Tommy Joyce Stockton, California 95201 City of Escalon <br /> Earl Pimentel City of Manteca <br /> Virginia Mathews (209) 466-6781 City of Ripon <br /> Daniel L Flores Clty of Stockton <br /> John 0.Mast,M.D. Jogl Khanna,M.D.,M.P.M.,District Health Officer City of Tracy <br /> Gene S.Kraham San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at North Sacramento and Fast Miner Avenue Stoekton, 6l1 95205 <br /> hereby authorize Canonie Environmental Services Corp_ <br /> to release any and all analytical results , geotechnical 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 . r�7 kl'Owner/Operator: v Title: '- <br /> Address One Market aza Room 1007 San Francisco, CA. Phone: (415) 541-2385 <br /> 9416-5 - <br /> Date: <br /> 41 5Date: 1/ 4 <br /> EH 08 05 UGT 13 <br />