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j. NONE <br /> BOARD OF TRUSTEES I JOAQUIN LOCAL HEALTH DCT SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 an Joaquin County <br /> Anthonette van Spronsen City of Escalon <br /> Earl Pimentel Stockton, California 95201 City of Manteca <br /> Fern Bugbee209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jogi Khanna, M.D., M.P.H., District Health Officer an Joaquin County <br /> Mary Anna Love an 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 54-pp 1'AG r k G AJC <br /> hereby authorize CPtmt)A C- 6Ai6j&19aZ 11V4 Ttyr . <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_ _ X-w - 9j Title: <br /> Address �' - Phone:CZa 4) X73 �� ° <br /> Date: <br /> EH 08 05 <br />