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, 1 <br /> HOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> Lodi <br /> City of Jamas Culbertson. Pros. y San Joaquin County <br /> Patricia E. Vannucci, wnty <br /> Anthonetts Van 8pronae1801 East Hazelton Avenue. P. O. Box 2009 Guy or Eacaion <br /> Earl Pimenta! n California 95201 City o1 Manteca <br /> Stockton, aorna <br /> City of futon <br /> Fern Sugbee 209/46781 <br /> 6-8 <br /> Daniel L. Flores City <br /> of Stockton <br /> John D, Meat, M.D. Glty of Tracy <br /> William J. Wade Jogl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <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 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: .('11altz <br /> Address i Phone: <br /> Date: <br /> EH 08 05 <br />