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SOARO OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> City of Lodi <br /> James Culbertson, Pres. Sen Joaquin County <br /> Patricia E. Vannuccl, Secy 1601 East Hazelton Avenue, P. O. Box 2009 City of Escelon <br /> Anihonette Van Spronsen <br /> Earl plmentel Stockton, Callfornla 95201 City of Manteca <br /> Bugloss y ofity of Ripon <br /> Fern Bu <br /> 209/466-6781 City of Stockton <br /> Daniel L. Flores City of Tracy <br /> John D. Mast, M.D. <br /> J 1111sm J. Wads Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> l <br /> San Joaquin County <br /> airy 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 705 N. School Street, Lodi , CA <br /> hereby authorize Canonie Environmental , Stockton, CA (209) 983-1340 <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:A /A! _Title: 14,61�'-, <br /> Address J <br /> Phone: <br /> C24 AV <br /> Date: <br /> EH 08 05 UGT 13 <br />