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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> SERVING <br /> James Culbertson, Pres. <br /> Patricia E. Vannuccl, Secy City of Lodi <br /> Anlhonette Van Spronson 1601 East Hazelton Avenue, P. 0. Box 2009 San Joaquin County <br /> Earl PlmentelCity of Escalon <br /> Fern Bupbee <br /> Stockton, California 95201 Clty of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.O. City of Stockton <br /> City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anns 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 1120 Waterloo Road, Stockton , CA <br /> hereby authorize Canonie Environmental , Stockton, CA <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 /> MICHAEL A. POLLACK INVESTMENTS <br /> Owner/Operator: �_� j�fTitle: 44Z <br /> Z <br /> Address 14 Of Big Basin Way Phone: (408) 867-1080 (209) 463-7999 <br /> 0 <br /> Saratoga, CA 95070 <br /> Date: <br /> EH 08 05 UGT 13 <br />