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BOARD Of TRUSTEES <br />Al Crow, Pres, <br />Ead Platental, Vice Pros, <br />Tommy Joyce, soey. <br />James F. Culbertson <br />John 0. Mast M.D. <br />Virginia Mathews <br />Thomas Schubert, D.V.M, <br />Daphne Shaw <br />Harvey Williams. Ph.D. <br />SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br />1601 East Hazelton Avenue San Joaquin County <br />City of Manteca <br />Stockton, California 95205 City of Escalon <br />City of Lodi <br />JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER City of Tracy <br />City of Ripon <br />ENVIRONMENTAL HEALTH DIVISION San Joaquin County <br />(209) 468-3420 City of Stockton <br />San Joaquin County <br />AU-rHarts FZXZA-r10M -rO Mell--eAO= <br />-94- ANALYTICAL RESULTS <br />-K- GEOTECHNICAL DATA <br />IF THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br />LOCATED AT California Water service, Station 1, Lafayette Street, Stockton, CA <br />(STREET ADDRESS) (CfYfOl White Rock Rd., Rancho Cordova, <br />TV I <br />HEREBY AUTHORIZE McLaren Environmental Engineering, <br />(LABORATORY or CONSULTANT) <br />TO RELEASE ANY AND ALL ANALYTICAL RESULTS, 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: <br />(IF APPLICABLE) <br />OWNER/OPERATOR:.. jf <br />(PLEASE PRINT) (TITLE) <br />ADDRESS: <br />(UILIKO ADDRESS) <br />r j4 <br />(CITY) iswET—aip) <br />PHONE: <br />DATE: <br />EH23 041 Revised 1/89 <br />Administration <br />Clinical Services <br />Environmental Health <br />Public Health Nursing <br />468-3400 <br />468-3830 <br />468-3420 <br />468-3860 <br />Air Pollution <br />Community Services <br />Laboratory <br />ffl(;- <br />468-3470 <br />468.3820 <br />468-3460 <br />468.3280 <br />