Laserfiche WebLink
e00kKD of TRUSILLS SAN jOAGUIN LG%C'AL HEALTH LAS T RICT SERVING <br /> J.m, Q Gvibv*t•on, Pres. City of L&dI <br /> id.ry Ann4 Love,V4�e Pyvo. lfio T Eaut Haxehon Av enol. P.O. DvK 2409 °t--"or.r,uio county <br /> P.v1tl• E.V•nn�[CI,6.C'�. min Sa�.;vin Cot:nty <br /> To.+rnr.40rc• Stockton,California 95261 Cky of E•calon <br /> E.rt flmenbt GMy of M•ntec• <br /> VkQW61 Mathews (209) 456-8781 City of P" <br /> 0sr-W L Fioree City o1 sbcktun <br /> John D.Most,M.D. Jog(Khanna.MIA.,M.P.H.Okbid H*&M Officor City rd Tracy <br /> O•r,e&Kr•A•m San Jgoquln minty <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNXCAL DATA AND ' <br /> SITE ASSESSMENT INFORMATION _ <br /> r 1 , the undersigned owner and/or operator of ' the property and/or facility <br /> located at +) CA- <br /> hereby authorize k/ <br /> to release any and all analytical results , geotechnical data and 'sitc: <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 : L Tit.le:'OjL)1 6,e, <br /> Address 1on"e lr�0 - <br /> Date : O <br />