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ODA,RD OF TRUSTEES <br />James Culbertson, Pres. <br />Patricia E. Vannuccl, Secy <br />Anthonelle Van Spronson <br />Earl Plmentei <br />Fern 6uQDee <br />Daniel L. Flores <br />John D. Mast. M.D. <br />William J. Wade <br />Mary Anna Love <br />• <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 East Hazelton Avenue, P. 0. Box 2009 <br />Stockton, California 9.5201 <br />209/466-6781 <br />Jogl Khanna, M.D., M.P.H., District Health Officer <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 ate 3300 Newton Road, Stockton, CA <br />hereby authorize Canonie Environmental, 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 />Owner/Op rator: - it tl e: <br />Aa Phone: �'6� <br />Date../�/ It <br />EH 08 05 UGT 13 <br />SERVING <br />City of Lodt <br />San Joaquln County <br />City of Eacalon <br />city of Manteca <br />City of Ripon <br />Clly of Stockton <br />City of Tracy <br />San Joaquin County <br />San Joaquin County <br />