Laserfiche WebLink
x <br /> f <br /> i <br /> sellvl►ea <br /> easpo OF IRUS1E£S SAN J!OAau�N LOCAL HEALTH DISTRICT City of Lodi <br /> San Joaquin County <br /> j]mm#r Cuipehson,Pres. Cllr al Esealtln <br /> °atrlcla E. vannucct, Soc'y 1601 Easl Hazellcn Avenue, P.O. Box 2009 elly tll E3calMentn <br /> ,' nolle Ven�pronson Stockton,Calllornla 95201 City of Ripon <br /> gmenlel City of slochton <br /> :san Butloee 209/466-6781 City of Tlacy <br /> Janiel L. Floes San Joaquin County <br /> John D. Mast, M.oa Jopt Khanna, M.O., M.P.H.. Dlalrlcl Haelth 011lcer <br /> Viliiem J.Wada SenJoaquinCounty <br /> Aary knne Love <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFOWATION <br /> I, the undersigned owner and/or operator ;;f the property and/or facility <br /> located at 260 E. Main Street, Manteca, CA <br /> hereby authorize Canonie Environmental, Stockton, <br /> CA 983-1340 <br /> te <br /> to release any and all analytical results. chleland <br /> l <br /> tion to the San JoaLoHealthDistrictassaon <br /> s5Es.mQnt info7na <br /> provided to me or my <br /> as it is available and at the safe time it is <br /> _ representative. <br /> Title: Owner�r.eG <br /> Darner/Operator: Phone- - <br /> Address _ Y I - <br /> San Francisco, CA 94134 <br /> Date: `2'/ 0 <br /> F <br /> rn no nr. lirT t'1 <br /> .� 4 <br />