Laserfiche WebLink
90AAD GF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> J*ma4 Culbarlson, Pres. SERVI" <br /> Patricia E. Vannuccl, Secy City of t_odf <br /> Mthonatte Van Spronsen 1601 Fast Hazelton Avenue, P. O. Sox 2009 San Joaquin counly <br /> Earl PImenlel Stockton, Cal ltornia 95201 city of Escalon <br /> Fern Bupbas City Of Manteca <br /> Daniel L. Floras 209/466-6781 City of Ripon <br /> John 0, Most, M.D City Of Stockton <br /> W11Iltrtrla J. Wade Jopl Khanna, M.D.. M.P.H., District Health Officer City of Tracy <br /> A4 y Anne Lore 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 <br /> hereby authorize Canonie Environmental , Stockton,, CA <br /> to release any and all analtical results , geotechnical data and site <br /> assessment information to tC Ucal Health Authorities as soon <br /> as it is available and at the same time is is provided to me or my <br /> representative. / <br /> fi <br /> Owner/Operator: >� � '- Title:_ ` <br /> Addressr� _. �.�.; - Phone <br /> Date: <br /> ,r <br />