Laserfiche WebLink
BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> James Culbertson, Pres, <br /> SERVING <br /> Patricia E. Vann ucci, SecCity of Lodi <br /> Secy City <br /> Joaquin Anlhonetttle Van spronson 1601 East Hazelton Avenue, P. O. Box 2009 Counl r <br /> City of Escalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern Bugbee r <br /> Clt of RIOon <br /> Daniel L. Flores 209/466-6781 <br /> John D. Mast, M.D. City of Stockton <br /> City of Tracy <br /> William J. Wade Jogl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love 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 Z§LZ5 and 26618 N. Sacramento Road, Thornton , CA. <br /> hereby authorize Canonie Environmental <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 /> EW 24HO SCH L STRICT <br /> Owner/Operator: �� > {� ��" ct Q Title: 7u <br /> Address S � �V Phone: <br /> e A-- 9 F� <br /> Date: y/a -71 <br /> EH 08 05 UGT 13 <br />