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doARo or 1nUSVLES SAN JOAOUIN LOCAL HEALTH DISTRICT SERVINn <br /> Jarmo Culbenaon. Piad <br /> Patric(yhE. Vannuccl. Sac' City ofLodi <br /> Anil, '$a van soionacnr 1601 Easl Hazelton Avenue, P. O. Box 2009 SinJoaa�JnCounty <br /> C-1491 Escalon <br /> Eat infol Stocklon, California 95201 City of Maniaca <br /> Fain du$oaa <br /> 5antst L. Fioros 209/466-6781 City of Ripon <br /> City of Stockton <br /> John 0. Mail.M.D. City of Tracy <br /> N1111im J.Weds Jogl Khanna,M.D.. M.P.H., Dhorlct Health 011lcar San Joaryuln County <br /> .Lary Anne Lova San JOa6:ula County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT €NFORMATION <br /> j <br /> I, the undersigned owner and/or operator of the property and/or facility <br /> located at Por:'. of Stockton, 2201 W. Washington, Stockton, CA <br /> hereby authorize. Canonie Environmental, Stockton, CA <br /> to::release any and all analytical results, geotechnical data and site <br /> '�sswlent 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 /> PORT OF STOCKTON <br /> Owner/Operator: Ld.�-��reTitle: <br /> P-Ims P. 0. Box 2089 7 Phone: 946-0 46 <br /> Stockton, CA <br /> Dater <br /> - <br /> I <br /> En nA 05 UGT 13 <br />