Laserfiche WebLink
BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. <br /> Lodi <br /> Patricia E. Vannuccl, Sec' City of u <br /> Anthonette Van Spronsen y San Joaquin County <br /> 1601 East Hazelton Avenue, P. O. Dox 2009 unty <br /> City of Escelon <br /> Earl Plmentel Stockton, Callfornia 95201 City of Manteca <br /> Fern Bupbee 209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.M., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at 2904 Beyer Lane , Stockton, CA <br /> hereby authorize Canonie Environmental <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 /> ALLE N'S VALVEEY LOAM t <br /> Owner/Operator: . ,i% 2 — Title: <br /> Address CO Phone: g.3 / ' 3S 3 ,S <br /> Dater / VZ <br /> EH 08 05 UGT 13 <br />