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VOA1:0 Of TRUSTEES • <br /> Jame; cu(ban,on. Pro,. SAN JOAOUIN LOCAL HEALTH DISTRICT <br /> Palricl• E. Vannuccl, Secy, SERVING <br /> Anihanefle Van Splon]an 1601 East Hazelton Avenue, P. Clly of Lod( <br /> Earl Plmenlel O. Boa 2009 San Joaquin County <br /> StocktonCallforni952 <br /> Fern 9up0ee , a 01 city of Eacalon <br /> Daniel L. Flores 209/466 781 CITY of Manleca <br /> John D. Mast, M.D. City of Ripon <br /> William J. Wade City of Slocklon <br /> Mary Anna Love Jopl Khanna. m.o.. M.P.H., Dlelrlcl Health Officer City of Tracy <br /> San Joaquin County <br /> San Joaquin Counly <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 645 N <br /> St. Lodi Ca <br /> hereby authorize Cal ifnrnia Water lab <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 /> ' Sys-b,G� ...�c .' - <br /> OwnJ/Operator: <br /> Address _Title: a� <br /> �� Phone: <br /> \-U Cw <br /> r <br /> Date: vA K-V <br /> EH 08 05 UGT 13 , <br />