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BOAR] OF TRUSTEES SAN JOAOUIN LOCAL HEALTH D[STRICT SERVING <br /> Jalnas Cuitaarsson, Pros I, CIIj of LOW <br /> Palrlcis E. vennucct, Sac'y1602 East HazB1tOn Avenue, PGBUIfi 2QD`� San Joaquin Courtly <br /> Anihonalle van SRronson P. . City Of Eicalon <br /> Earl Plmanist Ssochlon, Calllofnin 911701 ! City of Mangoes <br /> Fun emobov l Gly of Ripon <br /> Z0�/468-6781 s City of Stockton <br /> Otnta1 L. Flora <br /> Joon 0. Maas, M.J. I T City of Tracy <br /> Wlfllam J.Wads Jogl Khanna, M.O.. M.P.H., District Hamill :7+near, San Josc,uln County <br /> Mary Anna tote I Sari Joaquin County i <br /> Ir <br /> 1 <br /> I� <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECKNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION I <br /> � a ' <br /> I, the undersigned owner and/or operator of the property and/or facility <br /> located at 23675 S. Air rt Way, Manteca CA <br /> hereby authorize Canonie Environmental•_Stocktton„nCA 10983 111340 . <br /> to release any and all analytical results, geotechnical data and site <br /> assessment information t0 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: Title: y? <br /> Address f .- Pho� f.: <br /> Date: <br /> Ii <br /> j <br /> 36 <br />