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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannuccl, Secy. <br /> Anthonette Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> City of Escalon <br /> Earl Plmentel Stockton, Callfornia 95201 City of Manteca <br /> Fern Bupbee <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of Stockton <br /> City of Tracy <br /> William J. Wade Jopl 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 INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at 5701 South Jack Tone Road, Stockton, Cali£, 95205 <br /> hereby authorize '--lifo"rnia Tater Taboratorv, 1.430 Carpenter Lane, Modesto, Ca, 95351 <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 nd at ;the ame time it is provided to me or my <br /> representative. <br /> J . o - ^dministrative <br /> Assistant <br /> Owner/Operator: Escalon TTnified School PistIict Title: <br /> Address 1520 Yosemite Ave Phone: 209 838-3591 <br /> Escalon, Ca, 95320 <br /> Date: 9 Jul 86 <br /> Ll�Vll <br /> ti <br /> JUL. 1 C INU80 <br /> ENVIRCMENTAL HEALTH <br /> F ERN11"i/SERVICES <br /> EH 08 05 <br />