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- ¢� +�,y-cam•"_.. � - �'�. � ,� .� . /> •i [ <br /> 'BOARD of TRUSTEES S � �JOAQUIN LOCAL H�gLTH'DlS 111CT� <br /> James Culbertson. Pres. <br /> Patricia E. VannucCI. SecSERVINGy. i <br /> City of Lodi <br /> Anthonetle van Spronsen 1601 East Hazelton Avenue, P. 0. Box 2009 <br /> Earl r San Joaquin County <br /> Fern Bu neeStockton, Call"fornia 95201. City of Escalon <br /> fl City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D, Mast, M.D. City of Stockton <br /> William J. Wade Jog[ Khanna, M.U., M.P.H., District Health Officer City of Tracy <br /> Mary Anna Love San Joaquin County <br /> San Joaquin County <br /> AUG 8 i98n <br /> ENVIROMENTAL HEALTH <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS GEOTECHNICAL .DATA AND FERMlT/SERVICES. <br /> SITE ASSESSMENT INFORMATION <br /> I, the undersigned owner and/or operator of the property and/or !facility <br /> located at 474 W. Gran line Rd. Tracy, Ca. 95376 i <br /> hereby authorize <br /> to release any and all analytical results, geotechnical data' and site <br /> r <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-ito me .or lily <br /> representative: <br /> Owner/Operator: T tamer <br /> Address 1137 Roosevelt Ave. Tracy, Ca. 5376 <br /> Phone: $35-0836 or 835-1817 <br /> - 1 <br /> Date: June 27, 1986 <br /> t <br /> A. <br /> z <br /> f <br /> t <br /> r <br /> 1 08 05 <br />