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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson. Pres. City <br /> PaIrIcl■ E. Vannuccl, Secof Lodi <br /> Joaquin of County San Joa <br /> Anlhonstle Van Spronson 1601 East Hazelton Avenue, P. O. Box 2009 q y <br /> Earl Plmenlel City of Escalon <br /> Fern Bupoee Stockton, Callfornia 95201 City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.O. City of Stockton <br /> City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anne Love <br /> San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 , the undersigned owner and/or operator of the property and/or facility <br /> located at 725 S. Fairmont Avenue, Lodi , CA 95240 <br /> hereby authorize Canonie Engineering <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. 7 <br /> Owner/Op <br /> erat <br /> Address ='725 S. Fairmont ( Phone: 369-3564 <br /> Lodi , CA 95240 <br /> Date: / ih- -2 /� 6 <br /> EH 08 05 UGT 13 <br />