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90ARb of IRus ICES SAN JOAQUIN LOCAL HEALTH OISTRI T SERVING <br /> ,Omer Culbertson. Pies. City of Lod[ <br /> slocla E. Vannucct. Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> nlhonette Ven Spronsen City ofEscalon <br /> Orf Plmentet Stockton, California 95201 City of Manteca <br /> ern Bupbee 209/466-6781 City of on <br /> anfel L. Flores Clly oâ–ºSlocktklon <br /> ,hn D. Mast, M.D. City of Tracy <br /> miam J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer Sen Joaquin County <br /> ary Anne Love _ San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1, the undersigned owner and/or operator of the property and/or facility <br /> located at 4IcxKIY)N ulmel (FMFTFRY STOCKTON A <br /> hereby authorize > r GO T ARDRATM of SITl(R'R7N ('A <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment 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 /> repres; ntative. / <br /> Owned/Operat Title: c/ <br /> Address S RURAL CII4F.TERY Phone: <br /> I;lmEE'TERy LANE, STO=N CA. 95201 ' _ <br /> Gate: <br /> :29 AIX J988 <br /> i If 0H 05 UGT 13 r <br />