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ii <br /> BOARD OF 1RUSIEES SAN JOAQUIN LOCAL HEALTH DISI HICT SERVING` <br /> James Culpenson. Pres. <br /> Palrlcla E. Vannuccl, Secy. Clty of Lodi <br /> Anlhonells Van Spionsen .1,601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Eerl Plmenlel Stockton, Callfornia 95201 City of Escalon <br /> Fern Bu oee City of Manteca <br /> Daniel L. Flores 209/466-6781 <br /> City of Ripon <br /> City of Stockton <br /> John D. Mast, M.O. City of Tracy <br /> William J. Wade Jopt Khanna, M.D., M.P.M., District Health 011lcw San Joaquin County <br /> Mary Anna Love 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 1711 Yosemite @ Hwy 99 <br /> hereby authorize w.F: Lewis construction, Inca <br /> to release any and all analytical results, geotechnical data and site <br /> cssessment 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 /> /z., <br /> OwnJ/Operator: Title: Owner <br /> Address 1711 Yosemite @ Hwy 99 Phone: (209) 823-4715 <br /> Manteca, California <br /> Date: <br /> EH 08 05 UGT 13 <br />