Laserfiche WebLink
ADARD OF TRUSTEES JOAQUIN LOCAL HEALTH DORICT SEAViNG <br /> Al Crow,Pres, W San Joaquin C,,--,ay <br /> Earl PlmeMef,Vice Pres. 1601 East Hazelton Avenue <br /> City of MG.)Ao8 <br /> Tommy Joyce,sec y. Stockton, California 95205`;i � � I� city of 13ec wn <br /> James F.Culbertson t City of 1-01 <br /> John 0.Mast,M.D. JOOI KHANNA, M.D., M,P,H„ DISTRICT HEALTH ofmm 444••v City of Tracy <br /> Virginia Mathews %I, ��,p <br /> Thomas Schubert D.V.M. ENVIRONMENTAL HEALTH DIV IBfOt�4' 21 1989 City ofr,Ipan <br /> Daphne Shaw (209) 458-3420 San Joaquin County <br /> Harvey Williams,Ph.D. CNVP3iMFNiAL HEALTH City of Stockton <br /> PERMIT/SERVICES San Joaquin County <br /> AIJThlL�K2I ZATION Tp RM LEAE3E <br /> 46- ANALYTICAL RESULTS <br /> H101- GEOTECHNICAL DATA <br /> i+ ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNER AND/OP, OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 312 S . Lincoln Street, Stockton, CA <br /> (STREET ADDRESS) (CITY) <br /> HEREBY AUTHORIZE__SENCo <br /> (LABORATORY of CONSULTANT) <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTSr GEOTECHNICAL DATA AND/OR <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAQUIN LOCAL HEAL. <br /> DISTRICT AS SOON A5 IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: California Department of Transportation <br /> (IF APPLICABLE) <br /> OWNER,/OPERATOR: Charlese R. Brown Underground Storage Tank Coord . Dist . 1 <br /> /(iPLE E PRINT) (TITLE) <br /> (S16NATUAE) <br /> ADDRESS: P.O. Box 2048 <br /> (NAILING ADDRESS) <br /> Stockton, CA 95201 <br /> (CITY) (STATE) (zip) <br /> PHONE: (_ 209 ) 948-7406 <br /> DATE, February 16 , 1989 <br /> EH 23 041 Revised 1/89 <br /> Administration Clinical Services Environmental Health Public Health Nursing <br /> 468.3400 468-3830 468-3420 468-3880 <br /> Alt Pollution Community Services Laboratory MC <br /> 488-3470 468-3820 488-3460 488.3280 <br /> AIDS Inlnrmatlnn 4Ah.1A4n <br /> 1d 6S GT 6911VTi7-0 PUJS <br />