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i <br /> 11116ASO CV TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. <br /> Patricia E. Vannuccl, Secy City of Lodi <br /> Anthonelte Van Spronson 1601 East Hazelton Avenue, P. 0. Box 2009 Sen Joaquln County <br /> Earl Pimenlel Stockton, California 95201 City of E3ce1on <br /> Fern Supbee City of Maniacs <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John 0. Mast, M.D. City of Stockton <br /> William J. Wade Jogl Khanna, M.D. M.P.N.. District Health Officer City of Tracy <br /> San Joaquln County <br /> Mary Anna Love <br /> San Joaquin County <br /> i <br /> I <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 260 E. Main Street, Manteca, 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. <br /> Owner/Operator: �L ���' -Title: Ownerr�G <br /> Address _�3Ya1_e St _ Phone: (415) 586-0639 <br /> San Francisco, CA 94134 <br /> Date: <br /> I <br /> ri., nol <br /> nc I('T t 2 <br />