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-BOARBof IRUSIEES SAN OAQUIN LOCAL HEALTH DISTRO SERVING <br /> James Culbertson, Pres. <br /> Pa Vicla E. Vannuccl, Secy. City of Lodi <br /> Anlhonette Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Earl Pimentel Stockton, California 95201 City of Escalon <br /> Fern Bup bee City of Manteca <br /> Daniel L. Flores 2097466-6781 City of Ripon <br /> John D. Mast, M.D. 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 Anna Love San Joaquin County ISI <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 2647 MT. DIABLO AVE. , STOCKTON, CA <br /> hereby authorize WESTERN METER SERVICE INC. <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 /> Owned/Operator: Title: <br /> Address Phone: <br /> Date: <br /> EH 08 05 UGT 13 r <br />