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PUBLIC HEALTH SERVICES oPQLriN C <br /> SAN JOAQUIN COUNTY <br /> JOGI KHANNA M.D.,M.P.H. <br /> Health Officer <br /> P.O. Box 2009 . (1601 East Hazelton Avenue) - Srockron,California 95201 <br /> c9�iFORaP <br /> (209) 468.3400 <br /> RECEIVED <br /> ENVIRONMENTAL HEALTH D'i V I',S 1 ON MAR 0 2 1990 <br /> (229) 4b8-34;='i <br /> AUTHCI FR I Z AT I C3 P4 TO FZEI—EAE3E <br /> ANALYTICAL RESULTS � <br /> * GEOTECHNICAL DATA <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/01i FACILITY <br /> LOCATED AT 1001 West Center Street, Manteca, California 95336 <br /> (STREET ADDRESS) i c.I TY: <br /> HEREBY AUTHORIZE KLEINFELDER, INC. <br /> [LABORATORY or [:ONSLIL TANT) <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL. DATA AND/OR <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION 1-0 SAN JOAQU i hl CUUN1-Y i�Ul_iL i C <br /> HEALTH SERVICES AS SOON A IT IS AVAILABLE AND AT THE SAME TIME IT 1S <br /> PROVIDED TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: City of Manteca <br /> -.--....... <br /> (IF OPF'LICAPLE:) <br /> OWNER/OPERATOR: Phil Sanguinetti Acting City Manager <br /> (PLEASE PRINT) i TI TLE) <br /> rsIGNP TUR4f <br /> ADDRESS: 1001 West Center Street <br /> (MAIL INS ADDRESS) <br /> Manteca, California 95336 <br /> (CI TY) i STATE) (2,IP) <br /> PHONE: ( 209 ) 239-8427 <br /> DATE: March 6, 1990 <br /> Ell cS 041 Revised 10/89 <br /> A Division of San Joaquin Counry Health C.arc Services <br />