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BOARD of TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James CuIDerlson, Pres <br /> Lodi <br /> Patricia E. Vannuccl, Secy San <br /> of San Joaquin County unty <br /> Anthonette Van Spronsen 1601 East Hazelton Avenue, P. 0. BOX 2009 <br /> Earl PlmCity <br /> off Ea <br /> Manteca entel Stockton, California 95201 t <br /> Fern Bugoee <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> City of Stockton <br /> John D. Masi, M.D. <br /> City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> AUTHOR!ZA T ION TO RELEAJE ANALYTI CAL RESULTS , GEOTECs{NI CAL DATA. AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at 1210 E. Victor Road, Lodi , CA 95240 <br /> hereby authorize Canonie Environmental , Stockton, CA 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 /> L�icr n o S*o6 K-4-o rl b <br /> Owner/Operator: C? __ Title: <br /> Address PD, it3 I LI C3 Phone: / 7 yZ <br /> ��oc_ 4c, v, (1.5: G 0 <br /> Date: <br /> EH 08 05 UGT 13 <br />