Laserfiche WebLink
lGARO Ox 1RU::TEES g, ,_4 JOAQUIN LOCAL HEALTH DIS i RICT <br /> James cult»nson. Pres. <br /> Palftcla E. Vannuccl. SaC'y. SERVING <br /> Anlhonatte Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaq?IVuin <br /> of cLodi <br /> ounty <br /> Earl Sugb ei Stockton, Callfornia 95201 vufn County <br /> Fern BupO•e Gty of Eacalon <br /> Daniel L Flores 209�46G-��8i city of Manteca <br /> John D. Mast, M.D. City of Rlpon <br /> William J. Wade City of Stockton <br /> Mary Anna Low Joel Khanna, M.O., M.P.H., Dlstrlot Health Officer Cliy of Tracy <br /> 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 100 Ventura - Stockton Ca. <br /> hereby authorize <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 /> Signature: lijo J <br /> Owned/Oper�or: i alvo TruckingCo, Title: <br /> Address P.O. B 665 VP-Sec. <br /> Phone: V�O <br /> San Francisco Ca. 94119 - 37L, -5— <br /> Date: <br /> a <br /> EH 08 05 UGT 13 r <br />