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'SOAAO OF TRUSTEES <br />Jamas Cuiba laoo. Prov. <br />Mary Anna Low, Vic* Pr". <br />►abto4 E. vannued. sae'y. <br />Tomo, Joyea <br />Earl Pknonfel <br />VM91nM Mathow, <br />Daniel L FW" <br />John O. Mut, M.D. <br />Oarw S. Kraham <br />S%ad JOAQUIN LOCAL HEALTH OIeRICT SERVING <br />1601 East Hazetton Avenue, P.O. Box 2009 <br />Stockton, California 95201 <br />(209) 466-6781 <br />J091 Khanna, MD, MJ.N. ofatrkt NaaM olaear <br />Cily of Lodi <br />Son Joaquin county <br />San Joaquin county <br />Chy of Eaealon <br />® City of Maniacs <br />��n Chy of Ripon <br />LC /1,a .. C h' of Stockton <br />4/ I rorl, Chy of Tracy <br />70; Joaquin County <br />F/Vj/k c; IP-o' <br />/Ijf <br />R�y�Ti64 F- �Tti <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECIINICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />I, the undersigned owner and/or operator of the property and/or facility <br />located atq137 k6�i L". --,.(J_1 i _ n .t. <br />l Y 11 <br />hereby authorize I� <br />to release any and all analytical results, geotechnical data and site <br />assessment information to the San Joaquin Local Ifealth District as soon <br />as it is available and at the same time it is provided to me or my <br />representative. <br />Owner/Op <br />Address <br />Dace: <br />Ell 08 05 UGT 13 <br />1e:Lu vI-Irl <br />ne: Zti"t • �itc�l ^� I <br />2cW-3G;�-3Z 75 <br />Ok <br />