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1 <br /> -BOARD OF IRUSI EES SAN JOAOUIN LOCAL HEALTH DISTRICT SERVING <br /> City of Lodi <br /> James CulDerleon. Pres. Sen Joaquin County <br /> Patricia E. Vannuccl, Secy 1601 East Hazelton Avenue, P. 0. Box 2009 City of Escalon <br /> Anthonette Van Spronnan City of Manteca <br /> Earl Plmenfel Stockton, Callfornia 95201 y <br /> City of Ripon <br /> Fern BuDuee 209/466-6781 City of Stockton <br /> Daniel L. Flores City of Tracy <br /> John 0. Mast. M.D. San Joaquin County <br /> WIIIIam J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer <br /> San Joaquin County <br /> Mary 'Anna Love <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 303 N. Pilgrim, 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 /> I <br /> Owner/Operator: Title: <br /> Address r Phone: 0_ <br /> Date: �a -7 <br /> EH 08 05 UGT 13 <br />