Laserfiche WebLink
�✓`moo' <br /> WW <br /> lop <br /> F080AOOF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> s 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 <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 Jog! Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at /0-/1f <br /> hereby authorize G� cj ;;'?h-- '-0-re'7e-h SPx �i��• �_ <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 /> Owner/Operator: _Title: <br /> Address /�z— �/e� At-7'e-AL f'z! Phone: <br /> Date: <br /> EH 08 05 <br />