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a0AR0 Of TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> SERVING <br /> Jamas Culbonson. Pres. <br /> Patricia E. Vannuccl. Secy City of Lodi <br /> AAlhonotls Van $proneon <br /> 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Earl Ptmontal Stockton, California 95201 it y of Ma <br /> Clt <br /> Form Supbee y of Manteca <br /> tec■ <br /> Daniel L. Floess 209/466-6781 City of Ripon <br /> John D. Mut, M.D City of Stockton <br /> City of Tracy <br /> William J. Wads Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary 'knno Lovo 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 - 2477 N. Wig Wam, Stockton, CA <br /> hereby authorize Canonie Environmental , Stockton, CA 983-1340 <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. L <br /> Owner/Operator: /�/� Title: OWAI�-iQ <br /> Address 1069 45th STREET Phone: 446-8044 <br /> SA(IlA6Em, CA 95819 <br /> Date: MAY 1, 1989 <br /> EH 08 05 UGT 13 <br />