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eDARD OF TRt18TEE8 . <br /> JOAQUIN LOCAL HEALTH DIMAICT <br /> AI Crow,Pres, SERVING <br /> Earl Pimenlel,vice Pres. 1601 East Hazelton Avenue sen Joaquin County <br /> Tommy Joyce.Seo'y. Stockton, California 95205 City of Manteca <br /> James F.Culbertson City of Esoalon <br /> John D.Mast,M.D. JOGI KHANNA, M.D.. M.P.H., DISTRICT HEALTH OFFICER City of Lodi <br /> Virginia Mathew$ City of Tracy <br /> Thomas Schubert,D.V.M. ENVIRONMENTAL HEALTH DIVISION City of Ripon <br /> Daphne Shaw (20S) 468-34�Q San Joaquin County <br /> Harvey Williams,PhD. City of Stockton <br /> A U y M 0 R X Z A-r 10 hN T O f-'� L E A E3 E San Joaquin County <br /> 40- ANALYTICAL RESULTS <br /> -114- GEOTECHNICAL DATA FEB 21 1989 <br /> -0+ ENVIRONMENTAL/SITE ASSESSMENT INFORMATION ENVi,;�;,;,,;LNTF�L Hr TH <br /> I, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT O S (,y . 1 cam,-,u -� .}.D k+z C A- <br /> (S1REE1 ADDRES )—"' (CIT(') <br /> HEREEiY AUTHORIZE r oc_ e jr c.! <br /> rLAaoRAroRr or c NsuLTANr) <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OR <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN J'OAQUIN LOCAL HEALTH <br /> DISTRICT AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME t U S Ac- <br /> (IF APPLICABLE) <br /> OWNER/OPERATOR: eVV'-( U S U-)L= i D LOC--LC— E5'6vAf�5 G2) <br /> (PLEASE PAINT) (TITLE) <br /> lSlBNATUR <br /> ADDRESS: A/&J .[�. ?:F-g- t <br /> (RAILINS ADDRESS) <br /> sA-,'- �A <br /> (crrr) <br /> (STATE) (ZIP) <br /> PHONE: ( Y(.f ) C 7.5� <br /> ..� .,. <br /> DATE r <br /> EH 23 041 Rsvi se~d 1/89 <br /> Administration Clinical Services Environmental Health Public Health Nursing <br /> 468-3400 468-3830 468-3420 468.38W <br /> Air Pollution Community Services Laboratory WIC <br /> 468-3470 468.3820 468-3480 468-3280 <br /> AIDS information 488.3820 <br />