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DOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> City of Lodi <br /> James Culbertson,Pres. San Joaquin County <br /> Mary Anna Lore,Vice Pres. 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> Patricia E.Vannucci,Secy. City of Escalon <br /> Tommy Joyce Stockton, California 95201 City of Manteca <br /> Earl Pimentel (209) 466-6781 City of Ripon <br /> Virginia Mathews City of Stockton <br /> Daniel L.Flores City of Tracy <br /> John D.Mast,M.D. Jogl Khanna,M.D.,M.P.H.,District Health <br /> officer <br /> San Joaquin County <br /> Gene S.Kraham <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS , GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and or op rator of t pro erty and/or facility <br /> located at r <br /> hereby authorize 0 <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 /> Owner/Operator: (1 Title: <br /> Address - �r Phone: 4skta tnit5 <br /> Date: <br /> DEC '7 1987 <br /> ENVtE�Mt/SER IC�S7H <br /> EH 08 05 UGT 13 <br />