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BOARD OF TRUSTEES *N JOAQUIN LOCAL HEALTH *RICT SERVING <br /> City of <br /> James Culbertson, Pres. <br /> Patricia E. Vannuccl, Sec'y. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonette Van Spronsen City of Escelon <br /> Earl Pimentel Stockton, California 95201 City of Manteca <br /> Fern Bugbee 209/466-6781 City of y ofity t Ripon <br /> Stockton <br /> Daniel L. Flores City of Tracy <br /> John D. Mast, M.D. <br /> William J. Wade Jog] Khanna, M.D., M.P.N., District Health Officer San Joaquin County <br /> Mary Anna 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 15634 South Steinegul Road, E�scalon, CA 95320 <br /> hereby authorize �....� s� ~d-(/ a<01`f(E_— rfGA/EFp5 <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. r 1 <br /> Owner/Operator: Title: S._4�4_ 4�- <br /> Address 26414East Lo Tree Road Phone: 465-7279 <br /> Escalon CA 95320 <br /> Date: April 8 1987 <br /> EH 08 05 <br />