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BOARD OrIRVSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> SERVING <br /> .lames Culbon3on. Pres. <br /> Palrlcia�E. Vannuccl, Secy. ad! <br /> Anthonette van Spronsen 1601 East Hazelton Avenue, P. 0. Box 2CA79 �SAX-W <br /> ntY <br /> Earl Pimentei Stockton, Callfornia 95201 lun <br /> Fern 8u@Uee Clty at Ma eca <br /> Daniel L. Floras 209/46"78111�y►! � 1'of Alpon <br /> ` <br /> John D. Mast, M.D. 140 City of Stockton <br /> William J. Wade Jogl Khanna, M.D., M.P-H., District Health Officer MEWk&T rty <br /> ENV1 <br /> Mary Anne Love R0 unty <br /> FERMI 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 525 W. Lockeford St. , Lodi , CA. <br /> hereby authorize Stockton Service Station Equipment Co . , Inc . <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 /> , <br /> Owner/Operator: Title: Co-owner <br /> Address p , 0, Box 560 Phone: (209) 334-5144 <br /> Lodes-CA. 95241 <br /> Date: Nov. 13 , 1986 <br /> EH 08 05 UGT 13 <br />