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bpAAO�Of��,IVS�-IEEi 4 t <br /> 60AA ywarl;on. ES SAN JOAOUIN LOCAL HEALTH DISTRICT <br /> Jame SEAvirro <br /> P.Iricia E. vannuccl. Sac'y, Cllyol Lodi <br /> Anlhonalle Van Spron24pn 1601 East Hazellon Avenue, P. O. Box 2009 San Joaquin <br /> Earl Plinanlal COunly <br /> Stockton. California 95201 City of Eacalon <br /> Fein8ugbaa City of Manteca <br /> Daniel L. Flores 209/166-6781 City of Ripon <br /> John D. Mail. M.O. Clly of Stockton <br /> William J. Wade Jogi Khanna. M.O.. M.p.".. Ofa1AC1 F{ealfh Offlcar CRY of Tracy <br /> Mary Anna Low Sart Joaquin County <br /> SrnQuin County <br /> I <br /> OEP 2 <br /> ENVIROMENTAL HEALTH <br /> fiERMrrjsERV10Es <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 ats/', F,k e <br /> hereby authorize <br /> to release any and all �anatical results. geotechnical data and site <br /> 61 <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: <br /> Title: <br /> Address -(S— <br /> rCJ12 Phone: --Y000 <br /> i <br /> i <br />�I r <br /> 104 08 05 UGT 13 <br />