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BOARD OF TRUSTEES SAN JUAOUIN LOCAL HEALTH DISTRI14. SERVING <br /> Jamaj Culbertson, Pre%. City of Lodi <br /> P■trtcla E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2D09 San JoaqulnCounty <br /> Anthonette Van Spronsen City of Escalon <br /> Earl Plmental Stockton. California 95201 City of Manteca <br /> Fern Bupbee 209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M-D. City of Tracy <br /> William J. Wade Jogl Khanna, M.D., M.P.H.. District Health Offlcer San Joaquin County <br /> Mary Anna Lore 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 a t :5(;7 ----EAST 11AIN ST, STOCKTON CA. <br /> hereby authori zeA41.LSEN LABORA716ff, 1318 BUWEISER CT, STOCK'ION, CA <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment 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/Operator: Title: <br /> Address V110 2 Phone: <br /> Date: S AUG 1988 <br /> I 11 08 05 LJGT 13 <br />