Laserfiche WebLink
' e0aR0 of IRus I EES <br />Jrmu CUIC+fon, Pref. <br />Pflflcef E. Vennuccl, Secy <br />Anlhonalte Van Spronsen <br />Earl Plmenlel <br />Fern Bupbee <br />Daniel L. Flores <br />John D. Mast, M.D. <br />William J. Wade <br />Mary Anna Love <br />SAI %OUIN LOCAL HEALTH DIST <br />—.1601 East Hazelton Avenue, P. 0. Boz 2009 <br />Stockton, Callfornia 95201 <br />209/466-6781 <br />Jopl Khanna, M.D., M.P.H., District Health Officer <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 Escalon Packers, Inc., 1905 McHenry Ave., Escalon, CA 95320 <br />hereby authorize California water Labs <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 />� w <br />Ownef/Opera <br />Address <br />Date: <br />I <br />19 <br />December 3, 1986 <br />EH 08 05 UGT 13 <br />, Escalon, CA <br />Title: Owner <br />838-7341 <br />SERVINO- <br />Clty of Lodl <br />San Joaquin County <br />City of Escelon <br />City of Manteca <br />City of Ripon <br />City of Stockton <br />City of Tracy <br />San Joaquin County <br />San Joaquin County <br />