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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. <br /> Patricia E, Vann ocol, SecClty of Lodi <br /> Anihy Sen <br /> Anlhonatltle Ven $D10W san 1601 East Hazelton Avenue, P. O. Box 2009 Joaquin County <br /> City of Escelon <br /> Earl Plmenlel Stockton, Calllornia 95701 City of Manteca <br /> Fern Bupbee <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Most, M.D. City of Stockton <br /> City of Tracy <br /> William J. Weds Jog[ Khanna, M.D., M.P,H., District Health 011lcer Sen Joaquin County <br /> Mary Anne 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 CCS/3,,J5�IC6_ 848 Fremont Street . Stockton CA <br /> r <br /> hereby authorize ,o�VOn�/f <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/Operator: C/ � . �arf�f,r-fir Title: <br /> Address S%C C rTo J g P. 0. BA 1288 Phone: 466-7041 <br /> Stockton, CA 95201 <br /> Date: February 11 , 1988 <br />