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HOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres <br /> City of Lodi <br /> Anlhonette Van Spronson PatriciaVann uccl, Secy 1601 East Hazelton Avenue, P. O. Box 20 09 San Joaquin County <br /> Anhonll <br /> Earl Plmentei Stockton, California 95201 ty f Eacebn <br /> Ci <br /> ty <br /> Fern Bupuee Clof Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> City of Stockton <br /> John D, Mast, M.D. <br /> City of Tracy <br /> William J. Wade Jopl 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 23675 S. Airport Way, Manteca, CA <br /> hereby authorize Canonie Environmental , Stockton, CA 983-1340 <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 salve time it is provided to me or my <br /> representative. <br /> Owner/Operator: a r.L f /��� �.,, r i Title: CV <br /> Address � 3 1 nom. �x :� Phone: <br /> Date: <br /> EH 08 05 UC" 13 <br />