Laserfiche WebLink
r�. <br /> SAJOAQUIN LOCAL HEALTH DIST SERVING <br /> N <br /> City of Lodi <br /> 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> We Pres. San Joaquin County <br /> nocci,sec y. Stockton, California 95201 City of Escalon <br /> panielL.Flores <br /> City of Manteca <br /> (209) 466-6781 City of Ripor <br /> ws City of Slocktor <br /> City of Tract <br /> . ,M.D. Jogi Khanna,M.D.,M.P.M.,District Health Officer San Joaquin Counti <br /> Gene S.Kraham <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS , GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operrat-or� of the property and/or facility <br /> located at X107 \ �ilahns � ` <br /> hereby authorize <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: � > t 'Z> Q Title: (-u <br /> Address d'. Ro-* • Phone : C17)-,Scy10 <br /> CP. 9-syj64 <br /> Date : <br /> EH 08 05 UGT 13 <br />