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.,....c of TRUSTEES <br />Jams, Culbenson, Pre,. <br />Patricia E. Vanuiueq. Soc. <br />Anlhonatl0 Van Spronaen Y. <br />Eart Pimento <br />Fern aupbea <br />Daniel L Flores <br />John D. Mast. M.D. <br />William J. Wade <br />Mary Anna low <br />SAODAQUIN LOCAL HEALTH OISTI&T <br />1601 East Hazeilon Avenue, P.SERVINo <br />California 952 <br />Stockton, 2 Box 2009 Gly of Lodi <br />01 San Jo•quin County <br />209/466-6781 City of Escaloo <br />City of Man face <br />Joel Khanna. M.D.,City of Ripon <br />M.P.H., Ofalrky Realm officer city of Stockton <br />Sao Joa Ity or Tracy <br />quln County <br />San Joaquin County <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />I, the undersigned owner and <br />located at ��C' /or operator of the property and/or facility <br />hereby authorize 1i I� c CY1 <br />to release an nO <br />y and all analytical results," <br />assessment informadata and tion to the San Joaquin Local Real thlDistrict aslte soon <br />as it is available and at the same time it is provided to me or my <br />representative. <br />Owned•/Oi <br />Address <br />Date: <br />f1 08 05 UGT 13 3 ' <br />tie: <br />one: <br />�•�JUIy 2�,, <br />1987 <br />ENVIROMENTAL HEALTH <br />FERMIT/SERVICES <br />n <br />