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ria" .BOARD OF TRUSTEES [` <br /> Sf, JOAQUIN LOCAL HEALTH D14,41CT SERVING <br /> James Culbertson, rres. Cltyof Lodi <br /> Palricla E. Vannuccl, Soc'y. <br /> Anlhonette Van S ronsen 1601 East Hazelton Avenue, P. D. Box 2009 San Joaquin County <br /> P City of Escaion <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> ,Fern Bugbee 209/466-6781 City of Filpon <br /> Daniel L. Flores <br /> John D. Mas;; M.D. City CiItt Stockton <br /> y of Tracy <br /> William J. Wade Jogl Khanna, MeD.. M.P.H., District Health Officer SanJoaqulnCounty <br /> 'Mary Anna Love San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL- RESULTS, GEOTECHNICAL DATA' AND <br /> E <br /> SITE ASSESSMENT INFORMATION <br /> I the undersigned owner and/or operator of the property and/or facility. <br /> located at 6700 Qrant _Li_at-Baal; Banta�CA_ Q <br /> hereby authorize Canonie Engineers Inc. <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 J.B. Terminal , 6700 Grant Line Road Phone. _941-g 3 <br /> _ <br /> Banta,' CA 45304_ <br /> Date: S <br /> EH 08 05 <br /> r <br />