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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> Al Crow,Pres. San Joaquin County <br /> Earl Pimenlel,Vice Pres. 1601 East Hazelton Avenue City of Manteca <br /> Tommy Joyce,Sec'y. Stockton, California 95205 City of Escalon <br /> James F.Culbertson City of Lodi <br /> John D.Mast,M.D. JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER City of Tracy <br /> Virginia Mathews City of Ripon <br /> Thomas Schubert.D.V.M. ENVIRONMENTAL HEALTH DIVISION San Joaquin County <br /> Daphne Shaw (20'3) 468-3420 City of Stockton <br /> Harvey Williams,Ph.D. San Joaquin County <br /> AUTHQFZ I ZAT I ON TO FSELEASE <br /> x ANALYTICAL RESULTS <br /> GEOTECHNICAL DATA <br /> +� ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNER, AND/OR OPERATOR, OF THE PROPERTY AND/OR, FACILITY <br /> LOCATED AT 540 West Scotts Avenue Stockton <br /> (STREET ADDRESS) 11CITY) <br /> HEREBY AUTHORIZE Clayton Environmental Consu tants <br /> (LABORATORY or CONSULTANT) <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: Acme Galvanizing Co. , Inc . <br /> (IF APPLICABLE) <br /> OWNER/OPERATOR: Sheridan Randolph President <br /> (PLEAS[ PRINT) (TITLE) <br /> 0 <br /> (SIGNATURE) <br /> ADDRESS: P.O. Box 23731 , Oakland, CA 94623 <br /> (NAILING ADDRESS) <br /> (CITY) (STATE) (ZIP) S,`\ <br /> U <br /> 415 <br /> PHONE: ( 444-8790 <br /> DATE: June 5 , 1989 <br /> \ <br /> EH 23 041 Revised 1/89 <br /> �lv�S C�c <br /> Administration Clinical Services Environmental Health Public Health Nursing <br /> 468-3400 468-3830 468-3420 468-3860 <br /> Air Pollution Community Services Laboratory WIC <br /> 468.3470 468-3820 468-3460 468-3280 <br /> AIDS Information 468-3820 , <br />