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BOARD OF IRuSTEES SAN JOAQUIN LOCAL HEALTH [)IST HICT SERV i No <br /> James Culbertson, Pres City of Lodi <br /> Patricia E. Vannuccl. Secy 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonetle Van Spronson City of Escalon <br /> Earl Pimenlal Stockton, California 95201 (',try tit Manteca <br /> Fern euQbeo 209/466-6781 City Ripon <br /> Daniel L Flores Clty of Stt ockton <br /> John D. Mast. M.D. City o1 Tracy <br /> William J. Wade Joel Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anne Lova 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 2211 N. Wilson Way, Stockton, CA <br /> hereby authorize Canonie Engineering <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/Operatdr: J ._ Title <br /> Address 2211 N. Wi l son Way_ _Phone: 466-2411-- <br /> Stockton , CA _ <br /> 1 <br /> Date: <br /> EH 08 05 11CT 13 <br />