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OF TRUSTEES <br /> J <br /> SAN - <br /> Jrme�� IUs <br /> Y naon, Pref. QUIN LOC - <br /> r'alrlUa E. vannuccl. Secy. AL HEALTH DISTAL <br /> Anlhonelte Van Soronaen <br /> Earl P,mnNel 1601 East Hazelton Avenue, P. SERVING <br /> Fern IJupbee Stockton0. Box 2009 Qly or Lod) <br /> , <br /> Daniel L. Flores California 95201 SanJoaQulnCi,unty <br /> John D. Ma,l, M.D. 209/466-6781Clly of Eacalon <br /> William J. Wade Clly of Maniac, <br /> Clty of Rlpon <br /> '.18ry Anna Love Jopl Khanna, M.D.. M.P.H., District Health olficer Clty of Stockton <br /> City of Tracy <br /> San Joaquin County <br /> San Joapuln County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the <br /> — Property and/or facility <br /> located at <br /> 6215 <br /> So- GINCO J� <br /> hereby authorize <br /> to release an �r O� <br /> y and all an results, geotechnical data and site <br /> assessment information to the San Joaquin Local Health District as soon <br /> as it is available and at the same time it is <br /> representative. provided to me or my <br /> Owned/Operator: <br /> Address % T Title: <br /> Phone: <br /> Date: <br /> f <br /> H 08 05 UGT 13 r <br />