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BOARD OF TRUSTEES SAN JOAOIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson Pres City of Lodi <br /> Patricia E Vannuccl SecySan Joaquin County <br /> Anthonelte Van Spfonsen 1601 East Hazelton Avenue, P O Box 2009 City of Escaton <br /> Earl Pimentel Stockton, California 95201 City of Manteca <br /> Fern Bupbee 209/466-8781 City of Ripon <br /> D L Flores City of Stockton <br /> J Mast. M D City of Tracy <br /> NIII1am J Wade Jogl Khanna, M.D , M P.H , District Health Officer San Joaquin County <br /> Mary Anne 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 107 N. School Street, Lodi , CA <br /> hereby authorize Canonie Environmental <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 /> Wepresentative. <br /> ' Mark N wfield <br /> Owner/Operator: �I Ti t1 e: �Ci?wl E[C <br /> Address 0. Bax Q Phone: 334-453 <br /> Woodbridge, CA 95258 <br /> Date: / 17 <br />• <br /> EH 08 05 UGT 13 <br />