Laserfiche WebLink
t <br /> BOARD of TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> Jeff*Cuiba*taon,Pro*. <br /> Mary Anna Love,Vic*Pros. of Lodi <br /> . 1601 East Hazelton Avenue. P.O. Box 2009 San Joaquin County <br /> P.trlcia E.Vannucci,sac'y. San Joaquin County <br /> Tommy d Pk JorconW Stockton,California 95201 City of Eacafon <br /> �EaA Pknanlaf <br /> City of Manteca <br /> �vir9f.ua MatMws (209 466-6781 City d Ripon <br /> L Fk►rsa City of Stockton i <br /> John D.mask M.D. Joo Khwwwk M.D..M.P."..Dk Md Hsafth of ew City of Tracy <br /> Bans&Kraham San Joaquin County i <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> Ir the undersigned owner and/or operator of the property and/or facility <br /> located at y31,5 W& uMf6-ronl 5T ECi 5TorICT9H C <br /> hereby authorize GEL <br /> to release any and all analytical results, geotechnical data and site, <br /> assessment information to the San Joaquin Local health District as soon i <br /> as it is available and at the same time it is provided to me or my <br /> representative . <br /> �A�#0 0 IAC/omQ�/� <br /> Owner/Operator: Title: <br /> Address 900 s. C e phone: <br /> i <br /> Lata : ell <br /> i <br /> EH 08 05 UGT 13 <br />