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BOARD OF TRUSTEES SA JOAQUIN LOCAL HEALTH DISI .,. <br /> James Culbertson,Pres. 'T SERVING <br /> Mary Anna Love,!rice Pres. 1601 East Hazelton venue, P.O. Box 2009 <br /> Patricia E.Vannuccl,Secy. 1601 City of Lodi <br /> Tommy Joyce <br /> San Joaquin County Earl Pimenlel Stockton, California 95201 San Joaquin County <br /> City of Escalon <br /> Virginia Mathews (209) 466-6781 City of Manteca <br /> Daniel L.Flores <br /> John D.Mast,M.D. City of Ripon <br /> Jogi Khanna,M.D.,M.P.H.,District Health Officer City of Stockton <br /> Gene S.Kraham City of Tracy <br /> 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 /33/33/ s. &"q-" Com. <br /> hereby authorize <br /> to release any and all analytical results , <br /> geotechnical data and site <br /> assessment information to the San Joaquin Local Ifealth District as soon <br /> as it is available and at the same time it is provided to me or my <br /> representative . <br /> C1�K 0f�- <br /> 9 Owner/Operator: <br /> ��Q�k. Title: <br /> Address �?_ t7i,� �,`-=fes { . <br /> .� Phone: 7O <br /> t� <br /> Date: <br /> EH 23 041 3/86 <br /> EH <br />