Laserfiche WebLink
TL <br /> OARO <br /> Of rAusSAN JOAQUIN LOCAL HEALTH DISTRICT <br /> Naa, <br /> JamaAM4s1 CuILerlson. t <br /> Palrlcla E. vannucclSEAVINO ! <br /> $aC'y. ity o!Co01 <br /> C <br /> Anthonelle Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San JOA ' <br /> Earl Plmenlel Quin County <br /> Stockton, California 95201 city of Escalon <br /> Fam Bugbee <br /> Manteca <br /> clof <br /> Daniel L. Flores 209/466-6781 City of <br /> John U. Maal, M.U. City City of Fit <br /> Stockton <br /> William J. WadeJog! Khanna. M.U,, M.P.H,. <br /> District Health of[Itsr Ctlyo[tract' <br /> Mary Anna tore San Joaquin County <br /> San Joaquin County <br /> f" <br /> ' I <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION E <br /> , j <br /> I , the undersigned owner and/or operator of the property and/or -facility <br /> located at `SSS' "wfs <br /> hereby authorize ff1,gal.� L.yr�,sa.r• s oma. mss- ,. <br /> 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 /> Owned/*operator: CiC . /( /a� Title: S z <br /> Address <br /> 5-A'-20 /ka-,2C Phone: ly <br /> i <br /> Date: <br /> r <br /> } <br /> t <br /> 1 Fl OS �_05-- �iJGT 13 <br />