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Soo <br /> BOARD of TRtNTEES SAN JOAOUIN LOCAL HEALTH DISTRICT <br /> Al Crow.Pres. San Joaquin County <br /> Earl Pimsntsl,Vice Pres. 1601 East Hazelton Avenue <br /> City of Manteca <br /> Tommy Joyce,sect• Stockton, California 95205 city of Escalon <br /> James F.Culbertson City of Lodi <br /> John D.Mast,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 (209) 468-3420 <br /> Harvey wmam .PhD. - City Stockton► <br /> San Joaquin County <br /> AUTHOR I ZAT I Oh! -ra RELEASE <br /> - - ANALYTICAL RESULTS <br /> - GEOTECHNICAL DATA <br /> -�- ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> Ir THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 1�5--N- Viral-Hollow Road Tracy <br /> (STREET ADDRESS) (CITY) <br /> HEREBY AUTHORIZE_ Geological Technics <br /> (LABORATORY or CONSULTANT) <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 REPRESENTATIVE. <br /> BUSINESS NAME: / I� <br /> (IF APPLICABLE) <br /> OWNER/OPERATOR; Robert Barenchi Owner <br /> (PLEASE KI) (TITLE) <br /> (alrxrATW1 -- _ <br /> ADDRESS: 1785 N. Corral Ho1,1ow Road <br /> (RAILIKB ADDRESS) <br /> Tracy CA 95376 <br /> (CITY) (STATE) (IIP) <br /> PHONE: ( 209 ) 478-6327 <br /> DATE: <br /> EH 23 041 Revised 1/89 <br /> Administration Clinical Services Environmental Health Public Health Nursing <br /> 468-3400 488-38M <br /> 80 <br /> 468-3420 488-38 <br /> Air Pollution Community Services Laboratory WIC <br /> 488-3470 468.3820 468-3460 <br /> 488-3280 <br /> AIDS Information 488-3820 <br />