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0 1111Aa <br /> BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISI ICT SERVING <br /> James Culbertson, Pres. <br /> Patricia E. Vannuccl, Secy. San Joaquin ty of ) <br /> in County <br /> Anthonelte van Spronsen 1601 East Hazelton Avenue, P. 0. Box 2009 <br /> City of Escelon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern Bupbee City of Ripon <br /> Daniel L. Flores 209/466-6781 City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love 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 21051 East Hiahwav 120. Escalon, Ca. 95320 <br /> hereby authorize ^alifornia water Laboratory+ 1430 Carpenter Lanes Modesto + Ca. 95351 <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 an at the s me time it provided to me or my <br /> representative. <br /> o Administrative <br /> Assistant <br /> . Owner/Operator: ESCALON UNTFIED SCHOOL DISTRICT Title: <br /> Address 1520 Yosemite Avenue Phone: 204 838_3491 <br /> Escalon, Ca. 95320 <br /> Date: 9 Jul 86 <br /> � tl ra <br /> JUL 1 o IY8b <br /> ENVIROMENTAL HEALTH <br /> FERMIT/SERVICES <br /> EH 08 OS <br />