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, IIJPUBLIC HEALTH SERVICES <br /> San Joaquin County <br /> BOARD OF MUSTEES P.O. Box 2009 •'' SERVING <br /> AE Craw.Pres.. ' (16@1 East Hazelton Avenue) S> p 2 29�g San Joaquin County <br /> Earl Pimental,Vice Pres. City of Manteca <br /> Stockton, , Californis 95201 City of Escaton <br /> ., Tommy Joyce,Secy. p�,i-1�ALj4� City a!Lodi <br /> James F.Culbertson vy )NMEN1 <br /> .,�. John D.Mast,M.D. JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFiC� �[tM1YISERVICES City of Tracy <br /> Mrginie Mathews City of Ripon <br /> Thomas Schubert,D.V.M. - ENVIRONMENTAL HEALTH DIVISION San Joaquin County <br /> Daphne Shaw' (209) 460--0420 City of Stocklon <br /> Harvey Williams,Ph.D. San Joaquin County <br /> AUTHMM I ZAT I CMN -rM MEL—EASE <br /> -�- ANALYTICAL RESULTS <br /> - - <br /> GEOTECHNICAL DATA ' <br />- i <br /> - ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I, ...THE. UNDERSIGNED OWN-EP.-AND/ORDPERATORt.OF�THE -PI=OPERTY;AND/OR-FAC I L-TTY <br /> LOCATED AT _ f 1 1 1 �C4y-cA -+- vim. <br /> (STREET ADDRESS) (CITY) <br /> HEREBY AUTHORIZE 6-2A (eL 'EC— <br /> { (LABORATORY or CONSBLTA T) <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/Oa <br /> f <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAQUIN LOCAL HEALTH <br /> DISTRICT AS SOON AS IT I5 AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE. <br /> f LOUSINESS NAME: —5�jg3QX MeatProcesZing Plant <br /> (!I APPLICABLE) <br /> OWNER/OPERATOR: P. Pete Reinstein Plant Manager <br /> (PifASE PRINT) (TITLE) - <br /> ADDRESS. P.O Box 8347 <br /> ' (RAILING ADDRESS) <br /> _ I . <br /> Stockton CA 93208 <br /> f` (CITY). (STAFF) (ZIP) <br /> i . <br /> L PHONE: ( 209 948-6440. <br /> '.DATE: <br /> EH 041 Revised 1/69 <br /> Administration Clinical Services Environmental Health Public Health Nursing <br /> 468-3400 468.3830 468-3420 468-3860 <br /> f <br /> Air Pollution Community Services Laboratory WIC <br /> 468.3470 468.3820 468.3460 460.3280 <br /> , AinR InFnrmnllnn Alan lnryq <br />