Laserfiche WebLink
BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> James Culbertson, Pres, SERVING <br /> Patrlcla E. Vannuccl, Secy Clty of Lodl <br /> Anthonette Van Spronson 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquln County <br /> Earl Plmentel Stockton, Calltornia 95201 Clly of Escalon <br /> Fern Bupbee City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of Stockton <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Ofllcer @4e <br /> ,/I City of Tracy <br /> Mary 4nne Love Joequln County <br /> �gyquln1ounty <br /> FNS SEG 1`� <br /> E tj*fNT /600 <br /> 'yil ql <br /> �F,�,7 FS�rti <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 1313 S. Stockton Street, Lodi , CA <br /> hereby authorize Canonie Engineering <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 /> Owner/Operator: l,C�� j Title: <br /> Address /3/3 S S 77e� TCA/ -57 - Phone: 3Z, <br /> 2 -//O <br /> Date: /a - /a - <br /> EH 08 05 UGT 13 <br />