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90AR0.OF TRUSTEES <br />Jam" CulbMson. PfH. <br />Mary Anna Low, Vica Pr.«, <br />P.trlcla E. vannucci, ti.c'y. <br />Tommy Joyco <br />E a rt F"*"W <br />vk9k94 Math*WV <br />DanW L Floe" <br />Jom O. Moat, M.O. <br />Deno 6. Kraham <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 East Hatetton Avenue, P.O. Box 2009 <br />Stockton, California 95201 <br />(209) 466-6781 <br />Jo9f Khanna. M.O, MAN., Dlatrtcf Naafth 01%c« <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />SERVING <br />City of Lodi <br />San Joaquin County <br />San Joaquin County <br />City of Eacalon <br />City of Ment*ca <br />City of Ripon <br />OtY of Stockton <br />City M Tracy <br />San Joaquin County <br />I, the undersigned owner and/or operator of the property and/or facility <br />located at <br />hereby auth <br />to release any and all analytical results, geotechnical data and sites <br />assessment information to the San Joaquin Local 1lealth 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: IJ& P�)jjjz, <br />/� I / �-1.-�1� C.�- (� dA Title: l.+'11 r, n 1 l <br />Address 2Z1 ll /�) c �� Phone: .3S <br />Date: <br />EH 08 05 UGT 13 <br />