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r <br /> SOAaD OF TRUSTEES &I JOAQUIN LOCAL HEALTH DIS,RICT seavlr+ncnyaf Lodi <br /> T James Culbertson, Pres, San Joaquin County <br /> Patricia E.Vannuccl, Secy. 1841 Cast Hazepon Avenue, P. 0, Box 2009 City o1 Escalon <br /> Anthonette Van SpronsenStockton,California 95201 city of Manteca <br /> Earl Pimento) City o1 Ripon <br /> Fern 6u9boe 2091466-6781 City of Stockton <br /> Cuof Tracy <br /> Daniel L. Floras San Joaquin County <br /> John D,Mast,M.D. jag]Khanna,M.D., M.P.H., District Health Officer San Joaquin County <br /> William J.Wade <br /> Mary Anna Love <br /> 1 <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> rator of the property andr'or •facility. <br /> ;, the undersigned owner and/or ope <br /> located at ;VAS rUA <br /> hereby authorize tS[ rtwFcc �lssdc <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 /> � <br /> Owner/Operator: Title: 67.*+-6/� <br /> Address l�i� trr�Z � Phone: 0 3C,�-fz�► <br /> Date: <br /> EH 08 05 <br />