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• ' � �,A f�i J;�l���:J(N f_OC;At : !LAL i N C;15 f F��T <br /> 1601 East H.lielton Ayenuo. P. O. Box 2009 <br /> .. ;f s V in `:,,�^r ion C.tty o`. �iC cl,;, <br /> Sto.kton, Cailfornia95201t c1tyof4�a:;,..._. <br /> t Fiore a� 209/466-6781 Ctly <br /> Clly of Sta_ktc+n <br /> M.a..3t. M.D. • Ctlro(Tracy <br /> !4'= J. ':'ode. Jog[ Khanna, M.t)„ M.P.H., ofatrict Health Officer San Joaqufn <br /> y r, a i_ors <br /> _ San Jo:qc:'n <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOIECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I. the undersigned owner and/or operator of the property and/or facility <br /> located at 19256 NORTH HWY 99, ACAMPO,CA 95220 <br /> hereby authorize Canoni_e_Engineering, 83 W: March Ln. ,5tockton:, 95207 <br /> to release any and all. analytical results. 11,otechnical data and site <br /> dssessr-ent 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 /> JIM FRESHOUR <br /> Ounet•/np.-ra tor: WESTERN OIL & SPREADING,INC Title: MANAGER <br /> Address 19256 NORTH HWY 99, ACAMPO,CA 95 ehone: 209-369-3631 <br /> Date: <br /> nowD t UTZ <br /> JAN 1 s 1987 <br /> ENVIROMENTAL HEALTH <br /> PERMIT/SERVICES, <br /> r., .n r ,rT 11 <br />