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BOARD OF TRUSTEES <br /> JameCulbertson,Pres. ON JOAQUIN LOCAL HEALTH DARICT SERVING <br /> s <br /> � <br /> Mary Anna Love,Vice Pres. 1601 East Hazelton Avenue P.O. Box 2009 City of Lodi <br /> Patricia E.Vannuccl,Secy. San San Joaquin County <br /> Tommy Joyce San Joaquin County <br /> Earl Pimenlel <br /> Stockton,California 95201 City of Escalon <br /> Virginia Mathews (209) 466-6781 City of Manteca <br /> Daniel L.Flores City of Ripon <br /> John D.Mast,M.D. City of Stockton <br /> Jogi Khanna,M.D.,M.P.H.,District Health Officer r•. City of Tracy <br /> Gene S.Kraham <br /> San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> f I , the undersigned owner and/or operator of the property and/or facility <br /> located at q S �J <br /> hereby authorize _ <br /> to release any and all analytical results , <br /> 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/Operator _Title: �_ �t��e11-5 ►� <br /> Address Phone: <br /> 4U,- I o <br /> Date: <br /> EH 23 041 3/86 <br /> Eli <br />