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v c r SAC IOAOUIN LOCAL HEALTH 01ST T <br />„h . <br /> r.Nt4 E. v.^nM„od. 6.c'ySERVING. <br /> Aeteoeafts V" lwona.n 1&01 East HaJellon Avenue, P. O. Dox 2009 San ;,M of Codi <br /> E.A PknsnJow <br /> t sl County <br /> F.,,, lupoaa Stockton. Calllornla 95201 Gty of Eacaton <br /> 06AW L Flores 209/4%1 781 cthof Maniacs <br /> John 0. Most. M.O. Gly of Ripon <br /> Gty of Stockton <br /> my <br /> J. Was' Jogl Khan, MA„ M.P.H� OlatrtU Hsaith fxlkar City of Tracy <br /> Mary Anna Cow San Joaquin county <br /> San JosQuln County <br /> JUN 10 1988 <br /> LTH <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA ANDNVIROMENTAL FERMIT/SERVICC S. <br /> SITE ASSESSMENT INFORMATION <br /> w I, the undersigned owner and/or operator of thero <br /> perty and/or facility <br /> located at P <br /> hereby authorize 37 r t sF Gl �I Cw, <br /> to release any and all analytical results, geotechnical data and site <br /> dssessawent inforvtation to the San Joaquin Local liealth District as soon <br /> as it is available and at the same Limit is provided to me or my <br /> representative. <br /> i <br /> Address Title: � a <br /> 8 3 - Phone: y <br /> Date: g� <br /> I <br /> r , <br /> EH 08 OS UGT 13 <br />