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BoAAo`oF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> SERVING <br /> James CuIDerl5on, Pres. <br /> Patricia E. Vannuccl, Secy. Clly of Lodi <br /> Anlhonette Van Spronaen 1601 East Hazelton Avenue, P. 0. Box 2009 San JoaquirtLaunly <br /> Earl Plmentel Stockton, California 95201 City of Escalon <br /> Fern Bupbee City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.O. City of StocktonCity of Tracy <br /> William J. Wade Jopl Khanna, M.O., 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 e 9&-:330 <br /> hereby authorizes- y / , <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment 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 /> Owned/Operator: ��. O�uQ ��cfu�s,�tifTitIe: <br /> Qom-L <br /> Address $S i; Phone: 5S. Ll� - 57 <br /> Date: <br /> EH 08 05 UGT 13 <br />