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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannuccl. Secy 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonette Van Spronson City of Escalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern 6uobee 209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jopi 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 /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at 107 N. School Street, Lodi , CA <br /> hereby authorize Canonie Environmental <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 /> Mark Newfield r/ y <br /> Owner/Operator: B/ Title: &t CO'i/�IGT�'✓ <br /> Address 0. Box Q Ij Phone: 334-453 <br /> Woodbridge, CA 95258 <br /> Date: /4 17 <br /> EH 08 05 UGT 13 <br />