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bGARG Or TRUSTLES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> James Culbertson, Pras. SERVING <br /> Patricia E. vannuccl, Sac'y Clty of Lodi <br /> Anlhonatle van Spronsun 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Earl Plrnsntal Stockton, California 95201 City of Escalon <br /> Farn Dupbou City of Manteca <br /> Daniel L. Floras 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of Stockton <br /> William J. WadeCity of Tracy <br /> Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anne Love San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS , GEOTECHNICAL DATA AND <br /> �8 <br /> SITE ASSESSMENT INFORMATION <br /> 1 , the undersigned--euA@v=a4Wff6or operator of the property and/or facility <br /> located at rrf , 1) <br /> f <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 /> -Operator: x /.,� �' Title: <br /> Address ��0. �rx 2CJ5 � Phone: (Zoy)9yy -3b w <br /> Date: <br /> EH 08 OS <br />