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BOARD OF TRUSTEES S/ ,dOAQUIN LOCAL HEALTH DIE�.i.T SERVING <br /> Lodi <br /> James Culbertson, Prps. �.► City of County <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. 0. Box 2009 San Joaquin County <br /> Anthonette Van Spronsen City of Eacalon <br /> Earl Pimento] Stockton, California 95201 City of Manteca <br /> City of Ripon <br /> Fern 9ugbe61 209/466-6781 <br /> City of Stockton <br /> Daniel L. Flores <br /> John b. Mast. M.D. CltyofTracy <br /> William J. Wade Jogi 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 I14FORMATION <br /> I, the undersigned owner and/or operator of the property and/or facility, <br /> located at 1050 Diamond Street, Stockton, CA 95205 <br /> hereby authorize Canonie Environmental Services Corp <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 /> Owner/Opera o Title: t� <br /> Address 1050 Diamon Street Phone: 467-6000 <br /> Stockton, CA 95205 <br /> Date: <br /> EH 08 05 <br />