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y <br /> DEEP 13 '39 14:57 PETRO}LEL :11GINEERING 7075457068 P. <br /> BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> AI Crow,Pres. San Joaquin County <br /> Earl Pir»entel,Vice Pres. 1601 East Hazelton Avenue City of Manteca <br /> Tummy JoyceF. <br /> dine ftonSec'yStockton, Callfornfa 95205 City of Escalon <br /> .!amen F,Culbe►taon City of Lodl <br /> John L', Mast,M.C. X041 KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER City of Tracy <br /> Virginia Mathews City of Ripon <br /> Thomas Schubert.D.v.M, ENVIRONMENTAL HEALTH DIVISION San Joaquin County <br /> Daphne Shaw (209) 468-3420 City of Stocklon <br /> Harvey Williams,Ph.O. San Joaquin County <br /> A►1�JTHC] I ZA-r X QN -r C3 tZE:L_I=— <br /> ANALYTICAL RESULTS <br /> -04- GEOTECHNICAL DATA <br /> -►� ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNER AND/CER OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> L.00'ATED AT 800 EAST HWY 12 LODI <br /> (SIRE[[ OPPRESS) (Clrr) <br /> HEREBY AUTHORIZE DUPONT BIOSYSTEMS - TRACE LABORATORIES <br /> f[A$ORATORr or CONSULTANT) <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA ANA/OFA <br /> E:NV I RONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN J OAQU I N 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 /> BUSINESS NAME: <br /> (IF APPLICABLE) <br /> OWNER/OPERATOR: .TOE COX, KAYO OIL COMPANY ENGINEER <br /> (PLEASE PRINT) (TITLE) <br /> lS16NATURE) <br /> ADDRESS i 800 NORTH ECKHOFF <br /> (NAILINB ADDRESS) <br /> ORANGE, CALIFORNIA 92613 <br /> (City) (STATE) flip) <br /> PHONE it 714 .) 634-4800 <br /> DATE-,. <br /> EH 23 041 Revi sOd 1/815 1 1 <br /> Administration Clinical Services Environmental Health Public Health Nursing <br /> 468.3400 469.3830 468-3420 468-3880 <br /> Air Pollullon Community Services Laboratory WC <br /> 468-3470 468-3820 468-3460 468.3260 <br /> AIDS infornmntion 415R-SA70 <br />