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.4 <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND SITE <br /> ASSESSMENT INFORMATION <br /> I, the undersined owner and/or operator of the property and/or facility <br /> located at do-,ti6� 05 ./5r21 Uu. CN�9i2rE2 ly4y s'roCtlfbry, <br /> hereby authorize <br /> to release any and all analytical results, geotechnical data and site <br /> �I <br /> assessment information to the San Joaquin Local Health District as soon as <br /> it is available and at the same time it is provided to me or my <br /> representative. <br /> Owner/Operator: 24Title: <br /> Address: Cid A 6-t-.A. W11le Phone: '146-Z'ero <br /> Date: <br /> I <br /> I. <br /> IN . <br />' �I <br />