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TRUSTEES <br />s CUlbertson, Pres. <br />Patrlcla E. Vannuccl, Sec'y. <br />Anthonette Van Spronsen <br />Earl,Pimentel <br />Fern Bupoee <br />Daniel L. Flores <br />John 0. Mast, M.O. <br />William J. Wade <br />Mary Anna Love <br />opAN JOAQUIN LOCAL HEALT (STRICT <br />1601 East Hazelton Avenue, P. O. Box 2009 <br />Stockton, California 95201 <br />209/466-6781 <br />Jopi Khanna, M.D., M.P.H., District Health Officer <br />Y 7 <br />aEC 2 , 1987 <br />ENVIROME/NSTAL tHEp �-� <br />EfvFERM T/SE�10E5, <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT TNPOPMATION <br />I, the undersigned owner and/or operator of.the property and/or facility <br />located at MARLOWE PROPERTIES, EAST WATERL001ROAD,,STOCKTON <br />hereby authorize RAWON <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 Phone: _hIQ <br />99' <br />Date: <br />EH 08 05'v I17� <br />SERVING <br />City of Lodi <br />San Joaquin County <br />City of Escalon <br />City of Manteca <br />City of Ripon <br />City of Stockton <br />City of Tracy <br />San Joaquin County <br />San Joaquin County <br />