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BOARD OF TRUSTEES <br /> James Culbertson,Pres. 1r'N JOAQUIN LOCAL HEALTH [ ,.4'RICT SERVING <br /> Mary Anna Love,vice Pres. <br /> Patricia601 East Hazelton Avenue, P.O. Box 2009 City of Lodi <br /> Tommy my E.Vannuccl,Sac'y. San Joaquin County <br /> Joyce <br /> Earl Pimentel <br /> Math Stockton, California 95201 San Joaquin County <br /> City of Escalon <br /> Virginia Mathews (209) 466-6781 City of Manteca <br /> Daniel L.Flores - City of Ripon <br /> John D.Mast,M.D. Jog[Khanna,M.D.,M.P.H.,District Health Officer City of Slocklon <br /> Gene S.Kraham r: City of Tracy <br /> 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 <br /> �STi7cr�TOy C.!t_ 9j�o?O� <br /> hereby authorize <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 . ,� Q <br /> 9 <br /> Owner/Operator: G�fZ�C/yiC� <br /> Address �eZ0 rS �j�.�c����� r�T Title: <br /> —.�TOG�i�77/1/ CyirQ i <br /> Phone: <br /> Afazo� - <br /> Date: <br /> Eli 23 041 3/86 <br /> Ell <br />