Laserfiche WebLink
F MGP 17 '89 89:54 PETROLE ENGIPiEERING 7075457068 P.= <br /> CJ OF TRUSTEESTRUSTEESAll.Crow, SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> w,Pres, SERVING <br /> Earl Pirftr,tel,vice Pros, 1801 East Hazelton Avenue San Joaquin County <br /> Tommy Joyce,Secy, StOckton, California 95205 City of Manteca <br /> Jaren F.Culbertson City of Escalon <br /> John D.Mast,M,O, JOGI KHANNA, KD,, M.P-H„ DISTRICT MEALTH OFFICER Cit'o1 Lodi <br /> Virginia Mathewa City of Tracy <br /> Thomas Schubert D.V,M, ENVIRONMENTAL HEALTH DIVISION CIN of Ripen <br /> Daphne Shaw f Z4�, y �iSB-� ;:U Sen Jgequin County <br /> Harvey Williams,Fh,D, City of Stockton <br /> San Joaquin County <br /> - <br /> ANALYTICAL RESULTS <br /> ' - GEOTECHNICAL DATA <br /> *� ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 800 EAST HWY 12 LODI <br /> (STREET ADDRESS) ICITY) <br /> HERLBY AUTHORIZE DUPONT BIOSYSTEMS - TRACE LABORATORIES <br /> (LA80RATORY or CONSULTANT) <br /> TO RELEASE ANY AND ALL. ANALYTICAL RESULTS, GeOTECHNICAL, DATA AND/OR <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATYCIN TO THE SAN JOAQUIN LOCAL HEALTH <br /> DISTRICT AS SOON AS 17' IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE;. <br /> "FAST GAS" <br /> DUSINESS NAMEe <br /> i <br /> (IF APPLICABLE) <br /> OWNER/OPERATOR: JOE COX, KAYO OIL COMPANY ENGINEER <br /> LL <br /> (PLEASE PRINT) (TITLE) <br /> I <br /> (S18NAFURE) <br /> ADDRESS: 800 NORTH ECKHOFF <br /> (NOIL06 ADDRESS) <br /> ORANGE, CALIFORNIA 92613 <br /> (CITY) (STATE) (IIP) <br /> PHONE- 71.4 ) 634--4800 <br /> DATE: 1�} <br /> EH 23 041 Revised 1/e'� f 1 <br /> Administration Clinical 5ervites Environmental Health Public Health Nursing <br /> 468.3400 460.3830 468-3420 488-3880 <br /> Air Pollution Community Services Laboratory WIC <br /> 4138-3470 489-3820 468.3480 <br /> 488-3280 <br /> ATOS InformatlOn 40a-192n <br />