Laserfiche WebLink
BOARD OF TRUSTEES <br /> AlCrow,Pres. <br /> $A' OAQUIN LOCAL HEALTH DIST <br /> -, <br /> Ear!Pimental Vice Prei <br /> Tommy Joyce,�,y 1601 East Hazelton Avenue SERVING <br /> .lames F.Culbertson Stockton, California 95205 Sart J084uln County <br /> John D.Mast,M.O. � Gly d Manteca <br /> Virginia M h6b9e JOG' KHANHA, M-D.. M.P. Clly of Ercalon <br /> Thomas Schu H•. DISTRICT HEALTH OFFICER <br /> Daphne Shaw D.V.M. ENVIRONMENTALCity of Lodi <br /> Harvey Williams,Ph.D. - HEALTH DIVISION City oar��, <br /> (209) 468--042 I) <br /> Sart Joaquin County <br /> AVTypR Z ZAT I01� TQ Re:L. Sart Jo qutnc+pW,h <br /> EAEE i. <br /> ANALYTICAL RESULTS <br /> ` GEOTECHNICAL DATA <br /> 'E+- ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I, THE UNDERSIGNED OWNER AND/OR OPERATOR <br /> LOCATED AT OF THE PROPERTY AND/OR FACILITY <br /> 4 Waterloo Rd. Stockton, CA 95205 <br /> HEREBY fslREf! I1DR(Ss1 <br /> ' �'"�Ly� <br /> AUTHORIZE LCC- <br /> TO RELEASE ANY AND ALL rUDORIrORr or C0611141r) , CA <br /> ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/p <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION T R + <br /> DYSTRICT AS SOON A5 IT IS AVAILA6LE AND O THE SAN JOAQUI�y LOCAL HEALTH <br /> AT THE SAME TIME IT IS PROVIDED <br /> '- TO ME OR MY REPRESENTATIVE, <br /> BUSINESS NAME: F & H Construction <br /> TIF AP1`11CIU[F1 <br /> OWNER/OPERATOR: <br /> IE�fSE 1 . <br /> (Itl[fj <br /> rSliD URli1 <br /> ADDRESS: 4945 Waterloo Rd. <br /> (r1111if RDDRESs) <br /> Stockton, CA 95205 <br /> (Crrr) <br /> rsrari:� rrlr� <br /> PHONE: ( 209 ) 931-3738 <br /> DATE: BS— 0'3- '?,7) <br />=H �3 041 Revised 1/B9 . •.. <br /> Administration <br /> 468-3400 Clinical Services <br /> 46a-3930 Environmental Health <br /> Air Pollution <br /> x-3420 PubliC Health Nursing <br /> �� . <br /> 468-3470 Community serAc" 466-3aw <br /> 46a_384 Laboratory <br /> 468-3160 %MC <br /> AIDS Information 464-3820 46a-3280 <br />