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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> AI Grow,Pres. San Joaquin County <br /> Earl Plmentel,Vice Pres. 1601 East Hazellon Avenue City of Manteca <br /> Tommy Joyce.Secy. <br /> Stockton,Californla 95205 Cly or Escalon <br /> Gly of Loll <br /> James F.Culberts <br /> on <br /> John D.Mast,M.D. JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER City or Tracy <br /> Virginia MathewsCly of Fgyon <br /> Thomas Schubert D.V.M. ENVIRONMENTAL HEALTH DIVISION San Joaquin County <br /> Daphne Shaw (209) 468-3420 City of Stockton <br /> Harvey Williams,PhD. San Joaquin County <br /> AU_r"C3 Z I ZAT I [7N TO 1 EL7 <br /> EASE <br /> - ANALYTICAL RESULTS <br /> - GEOTECHNICAL DATA <br /> -IN- ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT I.V300. 3�Lhlagt Road Clements Ca 95227 <br /> (STREET ADDRESS) (CITY) <br /> HEREBY AUTHORIZE <br /> (LADORATORY or CORSDLIANT) <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTSr GEOTECHNICAL DATA AND/OR <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAQUIN LOCAL HEALTH <br /> DISTRICT AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> • TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: _ rlaude C. Wood Co. <br /> (IF APPLICADLE) <br /> OWNER/OPERATOR: Represenative-- Dave Harrald Vice-President/Aggregates <br /> (PLEASE PRINT) (TITLE) <br /> (SI6llA10R <br /> ADDRESS: P C Box 599 <br /> (RAILIR6 ADDRESS) <br /> JQAj A 95241 <br /> (CITY) (STATE) (ZIP) <br /> PHONE: ( 249 ) 334-0790 <br /> DATE: August 22,1989 <br /> • EH 23 011 Revised 1/89 <br /> Administration Ciinical Servicos Environmental Health Public Hoalth Nursing <br /> 468-3400 468-3830 468-3420 468-3860 <br /> Air Pollution Community Services Laboratory vV10 <br /> 458-3470 <br /> 468-3820 466-3460 468.3280 <br /> AIDS Information 468-3820 <br />