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Jgm* Cultm THUS <br /> Pro$. s SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ���*+.s Cult>artson, Praa. SERVING <br /> Mary Anna Lora,Vice Pr.4, 1601 East Hazelton Avenue, P.O. 130K 2009 City of Lodi <br /> Patr$cla E.Vannuccl,sec'y. San Joaquin County <br /> Tommy Joyce Stockton, California 95201 San Joaquin County <br /> Earl Plment*l +VIrgtnICity of Escaiort <br /> DanWa Mal s (209) 466-6781 Ctty of-Manteca <br /> Dania) Flores City of Ripon <br /> John D.Meet,M.D. Ctty JoQi Kharwsa,M-D,M.P.H�Dlatrlct Health Ofacar d Stockton <br /> Gena 8,Kraham City of Tracy <br /> San Joaquin County <br /> f <br /> i <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA- AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 , the undersigned owner anal/or operator of the property and/or facility <br /> located at j S <br /> hereby authorize �✓ <br /> to release any and all analytical results, <br /> geotechnical_ data and sits: <br /> assessment information to the San Joaquin Local Health District as soon <br /> as it is avai able and at the m time it is - provided to me or my <br /> representative <br /> Owner/Operator: f <br /> Title ©cam .cp_ <br /> Add Tf!SS <br /> 0 . <br /> Pholl <br /> l)aLe , <br /> Eli 08 05 UGT 13 <br />