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a' <br /> 90ARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. l� �I City of Lodi <br /> Patricia E. Vannuccl, Secy San Joaquin County <br /> Anthonstte Van Spronson 1601 fast Hazelton Avenue, P. O. Boz 2009 <br /> City of Escelon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern 6upDae209/466-6781 ji City of Ripon <br /> Daniel L. Flores j ; City of Stockton <br /> John O. Mast, M.D. fI City of Tracy <br /> William J. Wade Jo91 Khanna, M.D., M.P.H., District Health Officer. Sen Joaquin County <br /> Mary Jknna Love San Joaquin County <br /> ii <br /> j <br /> j3 <br /> Il <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION j <br /> �3 <br /> ii <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at Port of Stockton, 2201 W. Washington , Stockton, j-CA <br /> hereby authorize Canonie Environmental , Stockton, CA, ;l <br /> to release any and all analytical results, geotechnical data and site <br /> assessment information to the San Joaquin Local Heal thiDistrict as soon <br /> i <br /> as it is available and at the same time it is providedto me or my <br /> representative. <br /> PORT OF STOCKTON <br /> Owner/Operator: a4eLdTitle- <br />: Address P. 0. Box 2089 Phone• 9�46-0 �46 <br /> Stockton, CA <br /> Date: /'�'(— — <br /> i <br /> 1 <br /> f i <br /> is <br /> ;i <br /> it <br /> f <br />