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-94- ANALYTICAL RESULTS <br />-w GEOTECHNICAL DATA <br />-'§- ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br />T, THE UNDERSIGNED OWNER, AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br />LOCATED AT 8!rL E. Hwy 12 Victor, Ca 9-5253 <br />(STREET ADDRESS) (CITY) <br />HEREBY AUTHORIZE Eureka Laboratories <br />(LABORAIORY or CONSULTANT) <br />TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OR <br />ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAOUIN LOCAL HEALTH <br />DISTRICT AS SOON AS IT IS AVAILADLE AND AT THE SAME TIME IT IS PROVIDED <br />TO ME OR MY REPRESENTATIVE. <br />BUSINESS NAME: Tre2haunn Nursery <br />(IF APPLICABLE) <br />OWNER;/OPERATOR: Herbert Preszler Property Owner <br />(PLEASE PRINT) (TITLE) <br />lS GNA11lRE) <br />ADDRESS: 306 LaSetta Dra Lodi Cao 9-5242 <br />(NAILTNO ADDRESS) 4 <br />Lo4j lie -5242 LltiVlROIVN1ENNTAL iEAL1+1 <br />(CITY) (STATE) (ZIP) P L F N11 SE -v iJ <br />PHONE: ( 209 ) 368-1545 <br />DATE: <br />1-11-RO <br />EH 23 041 Revised 1/89 <br />Administration Clinical Servicos Environmental Health <br />468-3400 468-3830 468-3420 <br />Air Pollution Community Services Laboratory <br />468-3470 468-3820 468-3460 <br />AIDS Information 463-3820 <br />Public Health Nursing <br />463-3860 <br />WIC <br />428-3280 <br />BOARD OF TRUSTEES <br />SAN JOAQUIN LOCAL HEALTH <br />DISTRICT <br />SERVING <br />Al Crow. Pres. <br />San Joaquin County <br />Earl Pimentel, vice Pres. <br />1601 East Hazelton Avenue <br />City of Manteca <br />Tommy Joyce, Secy. <br />Stockton, California 95205 <br />City of Escalon <br />James F. Culbertson <br />City of Lodi <br />John D. Mast, M.D. <br />JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER <br />City of Tracy <br />Virginia Mathews <br />City of Ripon <br />Thomas Schubert, D.V.M. <br />ENVIRONMENTAL HEALTH DIVISION <br />San Joaquin County <br />Daphne Shaw <br />(2o,3) 466-33420 <br />City of Stockton <br />Harvey Williams, Ph.D. <br />San Joaquin County <br />AUTHC7FZ I ZA-IF I C3 t\1 -rO <br />K:E:L-EA0E <br />-94- ANALYTICAL RESULTS <br />-w GEOTECHNICAL DATA <br />-'§- ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br />T, THE UNDERSIGNED OWNER, AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br />LOCATED AT 8!rL E. Hwy 12 Victor, Ca 9-5253 <br />(STREET ADDRESS) (CITY) <br />HEREBY AUTHORIZE Eureka Laboratories <br />(LABORAIORY or CONSULTANT) <br />TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OR <br />ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAOUIN LOCAL HEALTH <br />DISTRICT AS SOON AS IT IS AVAILADLE AND AT THE SAME TIME IT IS PROVIDED <br />TO ME OR MY REPRESENTATIVE. <br />BUSINESS NAME: Tre2haunn Nursery <br />(IF APPLICABLE) <br />OWNER;/OPERATOR: Herbert Preszler Property Owner <br />(PLEASE PRINT) (TITLE) <br />lS GNA11lRE) <br />ADDRESS: 306 LaSetta Dra Lodi Cao 9-5242 <br />(NAILTNO ADDRESS) 4 <br />Lo4j lie -5242 LltiVlROIVN1ENNTAL iEAL1+1 <br />(CITY) (STATE) (ZIP) P L F N11 SE -v iJ <br />PHONE: ( 209 ) 368-1545 <br />DATE: <br />1-11-RO <br />EH 23 041 Revised 1/89 <br />Administration Clinical Servicos Environmental Health <br />468-3400 468-3830 468-3420 <br />Air Pollution Community Services Laboratory <br />468-3470 468-3820 468-3460 <br />AIDS Information 463-3820 <br />Public Health Nursing <br />463-3860 <br />WIC <br />428-3280 <br />