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�? ' 9C 14 �4 R.H.L. ,-'�CRAMENT0 9166 164679 <br />B0ARD OF TRUSTEES SAN JQAQUIN LQ (;At. HEALTH DISTRtk 'I SE.AVING <br />At Crow, Area. San Joaquin County <br />Ear Pimentel, Vice Pres. 1601 East HBzefton AVenbe City of Manteca <br />To my Joyce, Secy. Stockton, California 95205 City or Escalon <br />James F. Culbertson city or Lodi <br />Jahn 0. Mast, M,O. J001• KHANNA, M.D., MY H., DISTRICT HEALTH OFFICER ��% City of Tracy <br />Virginia Mathews % 1i h City of Ripon <br />Thomas Schubert, D.V.M. ENVIRONMENTAL HEALTH DI V I S I O k Joaquin County <br />Daphne Shaw .(209) 46$^,, 420 City of Stockton <br />Hervey Williams. Ph.D. � h r San Joaquin County <br />^u_F"CJYom!T z ^_r x m" T>! ? <br />4�-.. ANAL.YT I CAL RESULTS-NVIRONMENTAL HEALTP <br />�FRMIITf �Fi?e/Ir'�^ <br />4w- GEOTECHNICAL DATA <br />-0t, ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br />it THE UNDERSIGNED. OWNER AND/OR'OPERATOR 'OF THE PRoRERTY AND/OR FACIL..ITY <br />LOCATED AT �. tl�i ►L ``C',:�__._. <br />,r. naw. nr r..wrv. <br />HEREBY AUTHORIZE M261.} 1A6V <br />• tlADORAJORY ar CO!!SfltrAifl) • ' I • <br />TO RELEASE ANY AND AL.L. ANALYTICAL: RESULTS, GI"OTECHNICAL DATA 'AN10/OR <br />ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JtOAQUIN LOCAL. HEALTH <br />DISTRICT -AS SOON AS IT IS AVA X LABL_E ' AND AT THE SAMG TIME IT I,S PROVIDED <br />TO ME OR MY REPPESENTATIVE. ' <br />BUSINESS NAME: - <br />(IF AFPLICABtE) <br />OWNER/OPERATOR: <br />tPt PIE PRCJfJ] {rlrLEt <br />��-�- <br />abd, <br />fS181tArIfRE? <br />ADDRESS. ,A-' Qo <br />()(BUNG ADDRESS) ' <br />(CITY) <br />PHONE:X0"1 Ce <br />DATE r 2 <br />EH 23 041 Revised I!B <br />Administration Clinical services <br />40.3400 468-3830 <br />Air Pollution Community Services <br />466.3470 488.3820 <br />AAA,O,-.f.._-__U_.. , <br />Environmental Health Public Health Nuraing <br />468-3420 4884860 <br />Laboratory WIC <br />406-3400 466-x'80 <br />