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BOARD OF TRUSTEES <br /> James Culbertson, Pro,_ SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> Patricia E. Vannuccl, So,,, SERVING <br /> Anthonette Van Spronson 1601 East Hazelton Avenue, P. O. Box 2009 San Joao CityinCof Lodl <br /> ounty <br /> Earl Plmenlel <br /> Fern Bupoee Stockton, California 95201 City of Escalon <br /> Daniel L. Flores 209/466-6781 city of Manteca <br /> John D. Mast, M.D. City of Ripon <br /> William J. Wade Jopl KhannaCity of Stockton <br /> , M.D., M.P.H., District Health Officer City of Tracy <br /> Mary Anna 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 1011 N. Broadway, Stockton , CA <br /> hereby authorize Cann ie Engineer,.ng <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:J / Title: Vice -Qesideiit <br /> Address SP�c/4cc-v o �� Phone: <br /> 11041 <br /> Date: //- 3 -B6 <br /> EH 08 05 UGT 13 <br />