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0 0 <br /> BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> AI Crow,Pres. San Joaquin County <br /> Earl Pimentel,Vice Pres. 1601 East Hazelton Avenue City of Manteca <br /> Tommy Joyce,Sec'y. Stockton, California 95205 City of Escalon <br /> James F.Culbertson City of Lodi <br /> John 0.Most,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 (211'3) 468-3420 City of Stockton <br /> Harvey Williams,PhD. San Joaquin County <br /> AUTHOFR I ZAT I ON TO FiEILEA0a <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 4350 N. Newton Road, Stockton, CA <br /> (S(REE)' ADDRESS) (209) 983-1340 <br /> HEREBY AUTHORIZE Canonie Environmental , Stockton, C <br /> (LABORAIORY or CONSULIAND <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OR <br /> ENVIRONMENTAL/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 REPREESnSENTATIVE. <br /> BUSINESS NAME: cJ7 �S <br /> (If APPLICABLE) <br /> OWNER/OPERATOR.: NleL ��� ��,P /� N� -✓ ( = <br /> ASEZz� PR/NI) (I(ELE) <br /> A <br /> (S16NA91URE1 / <br /> ADDRESS: _ & U�� —3 D!6/F'A) <br /> (NAILING ADDRESS) <br /> (CIS (SIAIE) (lip) <br /> PHONE: ( &3 <br /> DATE: 71101() <br /> EH 23 041 Revised 1/85 <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 468-3460 468-3280 <br /> AIDS Information 468-3820 <br />