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eOARU Of TRUSTEES SAN JOAQUIN LOCAL HEALTH L>I`� ���1111`J SERVING <br /> Jame! Culbertson, Pres t City of Lodi <br /> Palricla E. Vannuccl, Secy Sen Joaquin County <br /> Anihonatte van Speonsen 1601 East Hazelton Avenue, P. O. r <br /> �9� GltY of Eacdon <br /> Earl Pimeniai Stockton, California 99201 gEP City of Manisca <br /> EP ' City of Ripon <br /> Fan Bupbse <br /> Daniel L. Home 209/466-6784 v\ROM� 1y�Rv\CE$ Cltyof Stockton <br /> John D. Most. M.D EN � City of Tracy <br /> San Wade Jopi Khanna, M.D., M.P.M., District Health Otih�e� San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RE.SUL4S , GEOl0,H NIt,AL DATA ANO <br /> SITE ASSESSMENT INFORMATION <br /> I, the undersigned owner and/or operator of the property and/or, facility <br /> located at 177 S. Kelly, Lodi , CA _ <br /> hereby authorize Nelson Lab, 3948 Budweiser Ct. , Stockton, CA_ <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 /> UO KI3H A <br /> — — --' --- <br /> Owner/Operator: itle; <br /> Address 177 S. Kel 1 y -� Phone; — 34_31130 <br /> Lodi , CA 9:1?40 <br /> Date: 3/10/88 <br /> FH OR Os u'-1 13 <br />