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bOARo or IRUS1EEs SAN JOAOUIN LOCAL HEALTH DISTRICT <br /> James CulUerlson, Pre,. SERVINO <br /> Pa11ICia E. VannuCCI, Secy City of Lodi <br /> Anlhonelle Van $pron2an 1601 East Hazelton Avenue, P. O. Box 2009 San JoaQuln County <br /> Earl Plmenlel Stockton, Callfomia 95201 City of Escalon <br /> Fern Buobee Y Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John 0. Mast, M.O. City of Stockton <br /> Wllllam J. Weds Jogl Khanna, M.O., M.P.N., District Health Officer City of Tracy <br /> San Joaquin County <br /> Mary Anna Love San JoaQuln County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 , the undersigned owner and/or operator of the property and/or facility <br /> located at I <br /> hereby authorize44 <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 /> Owne�/Operator: r ` Title: ' <br /> Address Phone: <br /> o� <br /> Date: /-l '�, '� <br /> (Sddie (5. Wisner <br /> 717 Will9w Such <br /> Lod.,CA 91240 <br /> r <br /> EN 08 OS UGT 13 <br />