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11/06/89 10: 117 2 4650552 San oavuin Lbr 02 <br /> IICpJ-V,6-1'�>i'd la�c'1 F'k4u•I l.Iul�,aicr.vun a wwt��. ,�, . ...._....- . ._.- -- <br /> aOARO OF TRVSTEQB SAN JOAOUIN LOCAL HEALTH DISTRICT SERVING <br /> N Crow.Pref. San Joaquin County <br /> Earl Pimento,vice Pres. 1601 East Heieilon Avenue City of Manteca <br /> Tommy Jeyce.Spey. SIOCklon, California 85205 Cly or Eecalon <br /> Jnmef r.Cuiterlsen City Of Lodi <br /> John U.Math M.w$ JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OPrtCGR City of Tracy <br /> Virginia Mathews Clry <br /> Thomas Schubert O.v.M. ENVIRONMENTAL HEALTH DIVISION San dos itof Nppn <br /> y Count' <br /> Daphne snow (209) 469-3420 City of Stockton <br /> Henvey Williams.Ph.D. Sen Joaquin County <br /> �U71-10Fa I ZM1l orI,—arL1—= Eg EE <br /> aP ANALYTICAL RESULTS <br /> +1126 GEOTECHNICAL DATA <br /> '0*- ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNED AND/UR OPERATUR OF THE PROPERTY AND/UP FACILITY <br /> LOCATED ATsz ..._ <br /> (SEREE, f [DDRESS/ fCiEYl <br /> HEREBY AUTHORIZE <br /> ((ADORAIORY ar C�SgCI�J) <br /> TO RELEASE ANY AND ALL ANALYTICAL PESULTS, GEOTECHNICAL DATA AND/OR <br /> ENVIFONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAQUIN LOCAL HEALTH <br /> DISTRICT AS SOON AS IT I5 AVAILABLE AND AT THE SAME TIME IT IS PRUVIDED <br /> TO ME OR MY REPPV91ENTATIVE. <br /> BUSINESS NAME: - <br /> .........].L.S,AA..••Ir,.�> c'G �-a�..52..-.......�.�..,,P..._..._.-...-......�_.�.__.__— <br /> JIP APRICOW <br /> OWNER/OPERATORt T(jav <br /> (S! A EJ <br /> ADDRESSi (�_ <br /> EAAIL0 ADORES L 4 <br /> C <br /> (idlY1 fSIAlEI til►! <br /> PHONE: <br /> DATE! - — <br /> EII 2S 041 Revised I/G9 <br /> Adminhhatlon Clinical Services EnViromnenf3l Health Pubic Haalih Hursing <br /> 480-3400 499.3034 468.3420 40-308o <br /> At,Pollution Community£Services Laboratory WIC <br /> 460.3470 4683920 400.0400 400.3290 <br />