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PIOARD OF MUSTEES <br /> Jamal Culbertson,Nei, JOAQUIN LOCAL HEALTH DIICT <br /> SERVI} <br /> Mary Unna lane,vice rRn, 1601 East Ilaxellon Avenue, P.O. pox 2009 City of u, <br /> r'tifrlcia C.Vannuccl,5ec'y, Sen Joaquin Cou, <br /> Tommy Joyce Sar►Joaquln Cou, <br /> Enrf Pl;nnnlel Stockton, California 95201 <br /> Vfrginla Maff+awe City of Fecal <br /> Cily or Manfe <br /> Daidel LFlorae (209) 466-6781 <br /> John D.Maef, <br /> CRY or Rip <br /> rn Jogl Khanna.M.D.,M.P.H..Di�tricl ireagh Officer s e Int Ip ti b�, City of SlocMi <br /> Gene S.rCraham i� 1 ) Clly el Tra <br /> i. . San Joaquin Cour <br /> r <br /> AUTIfollIZATION TO RI:L]:ASIs ANALYTICAL RESULTS, GI:OTECIINICAL DATA AND <br /> SI'Z'E ASSESS&MNT INTOItfrfATION <br /> 10 the Undersigned Owner aild/or operator of the property and/or facility <br /> located at - y <br /> hereby authorize <br /> to release .any and all analytical results , geoteelr <br /> assessment information nical data and site <br /> to the Sun Joaquin Local Ilealth District as soon <br /> as it i5 available and a.t the :;ame time it is provided to me or my <br /> represen tiutive <br /> L <br /> Date: Ci <br /> Iii 23 041 3/06 <br /> EM <br />