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eoaftD .oF rBusrnes - , N JOAQUIN LOCAL HEALTH D iRICT SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Mary Anna Love, Vice Pre., 1601 East Hazelton Avenue, P.O . Box 2009 San Joaquin County <br /> Patricia E. Vannuccl, Secy, San Joaquin County <br /> Tommy Joyce Stockton, California 95201 City of Escalon <br /> Earl Pimentel _ City of Manteca <br /> Virginia MallceWs (209) 466 .6781 , , . . . . . . . City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. Jogl Khanna, M.D., M.P.H., District Health Officer - r' : City of Tracy <br /> Gene S. Kraham NOV 0 5 i990 San Joaquin County <br /> KLEINFELDER, INC, <br /> SACRAMENTO, CA ,;. ! <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 <br /> hereby authorize <br /> to release any and all analytical results , geotechnical data and site <br /> assessment information to the San Joaquin Local Ilealth District as soon <br /> as it is available and at the same time it is provided to me or my <br /> representative . <br /> 9 Owner / Operator : L , Title : f Kik <br /> Address Phone : ( °f � S S f3d3 <br /> L: <br /> Date : <br /> Ell 23 041 3 / 86 <br /> Ell <br />