Laserfiche WebLink
BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannucci, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonette Van Spronsen , City of Escalon <br /> Earl Pimentel Stockton, California 95201 City of Manteca t <br /> Fern Bugbee 209/466=6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jogi Khanna, M.D., M.P._H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> .i <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 <br /> I, the undersigned owner and/or operator of the ptro.perty and/or facility, ;; <br /> located at 5491 F -St- Banta, CA 95304 , <br /> hereby authorize ETS Environmental p O Rom 2747 fMPrced _ CA-- <br /> to <br /> A 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 /> Jerry Dore � <br /> Owner/Operator: A Title: president l <br /> Addre§t-o. Box 67 ta, CA Phone: . (209)835-2750 <br /> Date: 7-22-88 <br /> s <br /> i <br /> i <br /> j <br /> EH 08 05 <br /> 1 <br />