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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> James Culbertson, Pres. SERVING <br /> Patricia E. Vannuccl, Secy City of Lodi <br /> Anlhonelte Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Earl Plmantal Stockton, City of Escalon <br /> California 95201 <br /> Fern Bugbee City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of Stockton <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer City of Tracy <br /> Mary Anne Love San Joaquin County <br /> 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 5503 S. Airport Way , Stockton , CA <br /> hereby authorize Canonie Environmental _ <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 same time it is provided to me or my <br /> representative. <br /> San Joaquin Coun Mosquito Abatement <br /> Owner/Operator: Title: yfl�►jr , <br /> Address 3 S. Airport Way Phone: 982-4675 <br /> Stockton, CA <br /> Date: <br /> —7 r <br /> EH 08 05 UGT 13 <br />