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30ARD.OF TRUSTEES SO JOAQUIN LOCAL HEALTH DiSIMIiCT SERVING <br /> lames Culbertson, Pres. City of Lodi <br /> nary Anna Love,Vice Pres. 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> 'atricia E.Vannucci,Sec'y. San Joaquin County <br /> !ommy Joyce Stockton, California 95201 City of Escalon <br /> Tari Pimentel City of Manteca <br /> firginia Mathews (209) 466-6701 City of Ripon <br /> )aniel L.Flores City of Stockton <br /> ohn D. Mast,M.D. Jogi Khanna, M.D., M.P.N., District Health Officer City of Tracy <br /> lene S.Kraham San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at Western State Stone , 3030 S . Hwy 99 , Stockton , CA <br /> hereby authorize Crisp Tree & Construction Co . <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: Title: <br /> Address 3d30 yet 99' Phone: <br /> Date: <br /> EH 08 05 UGT 13 <br />