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BOARD OF TRUSTEES ON JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> Al Crow,Pres. <br /> Earl Pimentel,Vice Pres. 1601 East Hazelton Avenue San Joaquin County <br /> TommyJoyce,Secy. City of Manteca <br /> Stockton,California 95205 <br /> James F.Culbertson City of Escalon <br /> John 0.Mast M.D. JOGI KHANNA, M-D., M.P.H., DISTRICT HEALTH OFFICERCity of Lodi <br /> Virginia Mathews City of Tracy <br /> Thomas Schubert D.V.M. ENVIRONMENTAL HEALTH DIVISIONCity of Ripon <br /> Daphne Shaw (209) 468-3420 San Joaquin County <br /> Harvey Williams,Ph.D. City of Stockton <br /> Sen Joaquin County <br /> AUTHOFZ I ZAT I OM TO FRELLEASE <br /> ANALYTICAL RESULTS <br /> GEOTECHNICAL DATA <br /> +� ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I , THE UNDERSIGNED OWNER AND/OP, OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 5555 Sh_ippee Lane Stockton <br /> (STREET ADDRESS) (CITY) <br /> HEREBY AUTHORIZE7o Ac <br /> (LABORATORY or CONSULTANT) <br /> TO RELEASE ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OP, <br /> ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO THE SAN JOAQUIN LOCAL HEALTH <br /> DISTRICT AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: N/A <br /> (IF APPLICABLE) <br /> OWNER/OPERATOR: X Wells Fargo Bank, N.A., Trustee <br /> (PLEASE PRINT) (TITLE) <br /> Sandra RE6etz Gerald A. Shupe <br /> Associate Asset Manager Assistant Vice President <br /> ADDRESS: <br /> (NAI( N6 ADDRESS) <br /> RnrrnmPnrn C'alifnrnin 95814 <br /> (CITY) (STATE) (ZIP) <br /> PHONE: ( 916 ) 440-4941 <br /> DATE: February 27, 1989 <br /> EH 23 041 Revised 1/69 <br /> Administration Clinical Services Environmental Health Public Health Nursing <br /> 468.3400 468-3830 468-3420 468-3860 <br /> Air Pollution Community Services Laboratory WIC <br /> 468-3470 • 468-3820 468-3460• 468-3280 <br /> AIDS Information 468-3820 <br />