Laserfiche WebLink
BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. <br /> Patricia E. Vannuccl, Sec'y City of Lodl <br /> Anthonette Van Spronson 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Earl Plmentel Stockton, California 95201 City of Escalon <br /> Fern Bugbee City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of Stockton <br /> City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love 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 _ 250 N. Cherokee Lane Lodi CA <br /> hereby authorize Canonie Environmental <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: j�,�ra�— Title: DGlJ/2GS/ <br /> Address o��/O,c! �dJ/2Gif–!C� Phone:: — <br /> lC'��/ <br /> Date: __6– <br /> EH 08 05 LIST 13 <br />