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eftht OF TRUSTEES !1FAN JUAOUIN LOCAL HEALTH D131RICP SERVII <br /> James Culbertson,Pros. City of L <br /> Mary Anna Love,vice Pres. 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin cou <br /> Patricia E.Vannuccl,Secy. San Joaquin cou <br /> Tommy Joyce Stockton, California 95201 City of Esca <br /> Earl Pimentel <br /> City of Mantr <br /> Virginia Malhewf <br /> (209) 466-6781 City of Rif <br /> Daniel L.Flores <br /> City of Stock <br /> John D.Masi,M.D. Jogi Khanna,M.D.,M.P.H.,District Health Officer r. City of Tr: <br /> Gene S.Kraham <br /> San Joaquin Cou <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> / I , the undersigned owner and/o operator of the property and/or facility <br /> located at �� S' � (S, C . s �✓ �( � � A <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. <br /> a Owner/Operator: <br /> Title: � <br /> Address 3 3 - S6� S- `, <br /> / phone: _ <br /> c <br /> Date: <br /> Ell 23 041 3/86 <br /> til l <br />