Laserfiche WebLink
BOARD OF TRUSTEU <br />•AI Crow. Pres. <br />Earl Pimentel, Vice Prat. <br />Tommy Joyce. Secy. <br />James F. Culbertson <br />John D. Mast, M.O. <br />Virginia Mathews <br />Thomas Schubert. O.V.M. <br />Daphne Shaw <br />Hervey Williams. Ph.D. <br />101 JOAQUIN LOCALD*RICT <br />1601 East Hazelton Avenue <br />Stockton, California 85205 <br />JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER <br />ENVIRONMENTAL HEALTH DIVISION <br />( 209) 468-3420 <br />r <br />4* ANALYTICAL RESULTS <br />-r+- ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br />SERVING <br />San Joaquin County <br />City of Manteca <br />City of Escalon <br />city of Lodi <br />City of Tracy <br />Cly of Ripon <br />San Joaquin County <br />City of Stockton <br />San Joaquin County <br />I, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br />LOCATED AT 633 E. Victor Road <br />Lodi <br />(S1tfE► A1i1111SS1 (Curl <br />HEREBY AUTHORIZECondor Earth Technologies Inc. <br />(LAAORAIORY of CONSUliAN1) <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 rr AND AT THE SAME TIME IT IS PROVIDED <br />TO ME OR MY REPRESENTATIVE. <br />(BUSINESS NAME, Knox's Texaco Food Mart <br />DOWNER/OPERATI <br />(!f AthICA8lf1 <br />ADDRESS, _ 4571..No . Pershing Ave I <br />(NAILING AODAfSS1 <br />Stockton CA 95207 I <br />(C111) ($1410 (lip) <br />PHONE, (_.209) 478-0365 <br />DATE, 4-2-91 <br />EH 23 041 Revised 1/89 <br />Administration Clinical Services Environmental Health <br />466-3400 468.3930 469-3420 <br />Air Pollution Community Sanicea Laboratory <br />468.3470 468.3920 468-3460 <br />Ainn tnrnrmafiM ®C.A_9Q7n <br />Public Health Nursing <br />469-3860 <br />WIC <br />468-3290 <br />