Laserfiche WebLink
%.r I%d <br /> BOARD or tRUStEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> James Cultallfon, P,ea. SERVING <br /> PeIrIUa E. Vannuccl, Secy City of Lodl <br /> Anlhonelle Van sprnneen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Ead Pimentel Stockton, California 95201 City of Escaion <br /> Fern 6ugoee City of Manteca <br /> Daniel L. Florae 209/466-5781 City of Ripon <br /> John D. Mari, M.D. City of Stockton <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health officer City of Tracy <br /> Mary Anna Love San Joaquin County <br /> 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 yj <br /> hereby authorize <br /> to release any and all analytical results, geotechnical data and site <br /> -issessment 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 /> 1�etf ,�. <br /> Owned/Operator Title: <br /> Address Phone: ,�jy Shy 9� r3 <br /> Date: <br /> EH 08 05 UGT 13 a <br />