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�/ <br /> ';BOARD OF TRUSTEES S0wiJOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> - AI Crow,Pres. San Joaquin County <br /> >.' Earl Pimentel,vice Pres. 1601 East Hazelton Avenue Cory Manteca <br /> Joaquin <br /> M <br /> Tammy Joyce,Secy. Stockton, California 95205 city of anteca <br /> James F.Culbertson <br /> John o.Mast,M.D. JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER City of Lodi <br /> Virginia Mathews City of Tracy <br /> Thomas Schubert,D.V.M. ENVIRONMENTAL HEALTH DIVISIONcity of Ripon <br /> San Joaquin County <br /> Harvey Williams,Ph.D. <br /> Daphne Shaw ('209) 468-3420 City of Stockton <br /> San Joaquin County <br /> AUTHOR I ZAT I Oh! -rC3 RELEASE <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 11181 E. Baker Road _ Stockton, CA <br /> (SIREEAD RES ) (CITY) <br /> HEREBY AUTHORIZE Alk' <br /> P-,-,,_ _QL <br /> (LABORAIORY or CONSRIANT) <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTE:HNIr_AL DATA AND/OP. <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAUUIN 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: Bill _Ca_m_inata _ <br /> WSAME <br /> PPLLCABLF) <br /> OWNER/OPERATOR: OWNER <br /> (T1ILE) <br /> ADDRESS: 10 West Walnut St. Stockton, CA 95204 <br /> (NAILINS ADDRESS) <br /> Stockton_ CA 952.04 <br /> (CITY) A-� (STATE) (ZIP) <br /> PHONE: ( M <br /> DATE: <br /> EH 23 041 Revised 1/89 <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 />