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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> Al Crow,Pres. San Joaquin County <br /> Earl Pimentel,Vice Pres_ 1601 East Hazelton Avenue City of Manteca <br /> Tommy Joyce,Secy Stockton, California 95205 City of Escalon <br /> James F.Culbertson City of Lodi <br /> John O.Meat,M D JOGI KHANNA, M D. M.P.11, DISTRICT HEALTH OFFICER City of Tracy <br /> Virginia Mafhews City of Ripon <br /> Thomas Schubert,D v M ENVIRONMENTAL HEALTH DIVISION San Joaquin County <br /> Daphne Shaw (209) 468--3420 City of Stockton <br /> Harvey Williams,PhD San Joaquin County <br /> AUTHOR I ZAT I ON T[7 IZEL-EASE <br /> -s«a- ANALYTICAL RESULTS <br /> - GEOTECHNICAL DATA <br /> -�- ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> It THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/PR FACILITY <br /> LOCATED AT Diamond and East Worth, Stockton y <br /> (STAEEI A1DRESS) (CIIY) <br /> HEREBY AUTHORIZE Environmental Solutions, Inc. <br /> (LABOIATORY or COISILIANT) <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: Stockton Fueling Facility <br /> (if APPLICABLE) <br /> OWNER/OPERATOR. <br /> Santa Fe Railway Company Manager Environmental and <br /> (PLEASE PAIND (TITRE) <br /> —(sisxATURE) <br /> ADDRESS: 5770 South Eastern Avenue <br /> (IAILIxs JOWSS) <br /> Los Angeles, CA 90040 <br /> (CITY) (SIAIE) (IIP) <br /> PHONE: t 213 ) 889-7767 <br /> DATE: <br /> • EH 23 041 Revised 1/89 <br /> Adminf*aow Clinkel Swim Enr kwvnental HOOM Public HooM Nursing <br /> 468-3400 468-3800 468-3420 469-3860 <br /> Air Pollution Community Services Laboratory IMC <br /> 468-3470 468-3820 460-3460 4668-3280 <br />