Laserfiche WebLink
)ARDkF TRUSTEES SACQUIN LOCAL HEALTH CISTOT SERVING <br /> mss Culbertson,Pres. City of Lod <br /> try Anna Love,Vice Pres. 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin Count) <br /> tricia E.Vannucci,Secy. San Joaquin Count? <br /> mmy Joyce Stockton, California 95201 City of Escalor <br /> rl Pimentel City of Manleca <br /> -ginia Mathews (209) 466.6761 City o1 Ripor <br /> oriel L.Flores City of Slocklor <br /> hn D.Mast,M.D. Jogi Khanna,M.O.,M.P.H.,District Health Officer City of Tract <br /> me S. Kraham San Joaquin Countl <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 S46L.'\ 10 n V c-) it, L= C-V4 <br /> hereby authorize Ec.N <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: G-A(iR.. t "i51 %t Title: <br /> Address (.,) ,' Phone: 916- 4'16 4Ua4 <br /> LtLa vvte.,to f.. Pr at 138 Irl- -S682 <br /> Date: fl o v 9 l 9 13 l <br /> EH 08 05 UGT 13 <br />