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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Cuibertson. Pres. <br /> Patricia E. Vannuccl, Secy. San Joaq Illn Couny of ty <br /> Anthonette Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 City of Escalon <br /> Earl Pimentel Stockton, California 95201 <br /> City of Manteca <br /> Fern Bu bee <br /> nanlel Flores 209/466-6781 cicy or Ripon <br /> City of Stockton <br /> ,ohn D. Mast, M.D. City of Tracy <br /> vviiiiam J. Wade Jopi Khanna, M.D., M.P.N., District Health Officer San Joaquin County <br /> l,ary Anna Love San Joaquin County <br /> AW HORI ZATION 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 -M AX <br /> hereby authorize �i ,L,c <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: Z.?�g Ti t e: AiRE«ae of())VCj?,4VCIW S <br /> Address Phone: qy6 ya <br /> Date: S//iA <br /> EH 08 05 UGT 13 <br />