Laserfiche WebLink
BOAhl) OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> SERVING <br /> James Culbertson, Pres. <br /> Patricia E. Vannuccl, Secy Clty of Lodl <br /> Anthonette Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquln County <br /> Earl Plmentel Stockton, Callfornla 95201 City of Eacalon <br /> Fern Sugoee Clty of Manteca <br /> Daniel L. Flores 209/466-6781 Clty of Ripon <br /> John D. Mast, M.D. Clty of StocktonGltyofTracy <br /> William J. Wade Jopi Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquln County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 , the undersigned owner and/or operator of the property and/or facility <br /> located at 305 W. Lodi Avenue, Lodi , CA <br /> hereby authorize Oannnie 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 /> Owner/Operator: t ,� .,� Title: <br /> Address 3 Phone: TI��, <br /> 64 <br /> Date: <br /> EH 08 05 UGT 13 <br />