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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson,Pres. City of Lodi <br /> Mary Anna Love,Vice Pres. 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> Patricia E Vannuccl,Secy. San Joaquin County <br /> Tommy Joyce Stockton, CalHomia 95201 City of Escalon <br /> Earl Pimenlel <br /> City of Manteca <br /> Virginia Mathews (209) 466-6781 City of Ripon <br /> Daniel L Flores City of' I .cklon <br /> John D.Mast,M.D. Jogi Khanna,M.D.,M.P.H,District Heatth Officer City of Tracy <br /> Gene S.Kraham San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1. 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: <br /> Address Phone: <br /> Date: <br /> K E KAPREALIAN ENGINEERING, INC. <br /> P.O. BOX 913 <br /> BENICIA, CA 94510 <br /> Since 1977 <br /> �0 Mobil Oil Corporation will not <br /> authorize the direct release of <br /> analytical data . They will forward <br /> the data and site assessment <br /> information compiled by Kaprealian <br /> Engineering upon receipt . <br /> EH 08 OS UGT 13 <br />