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BOAR <br /> James <br /> of TRun, Pro SAN JOAQUIN LOCAL HEALTH DISTRIC 4/ <br /> ES <br /> James Culbertson, Pres. 5 f� <br /> Patricia E. Vannuccl, Secy �.. � � RVINO <br /> Anlhonetfe Van Spfonson 1601 East Hazelton Avenue, P. O. Box 2009 �A(`� L�;, sen 7oaCOln County <br /> Earl Pimentel <br /> Fern Bupbae Stockton, California 95201 City of Escalon <br /> Daniel L. Flores 209/466-6781 ENVIROMENTAL H�41yQfNrmanloca <br /> John D. Mast, M.D. FERNIIT/ �y4 Ripon <br /> William J. Wade SERVICof Stockton <br /> Mary Anna Love Jopl Khanna, M.D., M.P.M., District Health Officer City of Tracy <br /> San Joaquin County <br /> 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 TRI/VALLEY, 26200 NONELL RD. , THORNTON, CA <br /> hereby authorize CALIFORNIA WATER TAR <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/Operator: <br /> Address Title: Q((QG <br /> Phone: <br /> Date: fZ— Zp— <br /> EH DR nri <br />