Laserfiche WebLink
130R1-40 01 1nUSItIS SAt*)AOUINLOCAL HLALIIiUISI &I <br /> INO <br /> Jame' Culberinon. Pre3. City <br /> f Lodi <br /> Puncta E. Vannuccl, Sec' Clly of Lodi <br /> Anlhonetle Van Sproneen <br /> y 1601 East Hazelton Avenue, P. O. Box 2009 San JoaQuln County <br /> City of baton <br /> Earl Plmentel Stockton, California 95201 City or Manteca <br /> Fern Bupoee 209/466 &781 <br /> Cityof of Stockton Daniel L. Flores <br /> City of Stockton <br /> John D. Mast. M.D. City of Tracy <br /> William J. Wade Jog( Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Lora 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 (-1 zc c00 '��K L�� C" <br /> hereby authorize <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment 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 /> Ownef/Operator: Title: CS��t o�z <br /> Address ,- S:7 hone: <br /> Date: <br /> a ,EH 08 05 UGT 13 <br />