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BOARD of TRUSTEES <br /> on. Pre SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> James CulDenson, Pres. SERVING <br /> Patricia E. Vannuccl, Secy City of Lodi <br /> Anthonette Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Earl PimenieiCity of Esceion <br /> Stockton, California 95201 <br /> Fern BupDee C]fyof Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of Stockton <br /> WilliCity of Tracy <br /> Mary m J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anne 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 1129 W. Sacramento, Lodi CA 95240 <br /> hereby authorize Canonie Environmental _ <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 /> Hol Rubber C pan <br /> Owner/Operator: 1, Title: c s . <br /> Address P. . Box 109 Phone: 368-7171 <br /> Lodi , CA 95241-0109 <br /> Date: <br /> EH 08 05 UGT 13 <br />