Laserfiche WebLink
EFS <br /> BOARD ul its on. P,, SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> James Culbertson. Prea. <br /> Patricia E Vannuccl, Sac'y SERVIND <br /> Anthonelte Van Spronsen 1601 East Hazelton Avenue, P. 0. Box 2009 Sen Joaquty of couool <br /> Earl Pimentel <br /> Fern Rup Duu <br /> Stockton, California 95201 city of Eacalon <br /> Daniel L. Flores 209/466-6781 City of Manteca <br /> John D. Mast, M.DCity of Ripon. City of Stockton <br /> Willi <br /> Mary Anna love J. Wade Jopl Khanna, MA. M.P.H., Dieirict Health Officer City of Tracy <br /> Mary ASan Joaquin County <br /> San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND OCT 2 1ybo <br /> SITE ASSESSMENT INFORMATION ENVIROMENTAL HEALTH <br /> FERRNT/SERVICES <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at t / . -& <br /> hereby authorize ZIAi/ JAZ,__ <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. <br /> " �'fBPe+'eEer W Title: <br /> Address <br /> Phone: <br /> Date: 9 <br /> it <br /> EH OR n5 <br />