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.0AP.O OI_I AV S I cc <br />�. �+.. C.IV.n.on. P.... <br />/.InpY (. V....Cci. S.0 t <br />Anthonalt• Van Solon... <br />(.I Plm.nla <br />O.nid L Flo(.. <br />John O. Most. M.O. <br />William J. wads <br />Mary Anna Lo,* <br />SAN JO"n [N LOCAL HEALTH DIST RIC,- — <br />1601 East Huelton Avenue. P. O. Doa 2009 <br />Stockton, Callfornia 95201 <br />209/166-6781 <br />Jool Khanns, M.D., M.P.H.. Olaldcl Health Office, <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />1. the undersigned owner and/or operator of the property and/or facility <br />located at 1100 E. Charter Way <br />hereby authorize _ Canonie Enginerring Inc <br />to release any and all analytical 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 provided to me or my <br />representative. <br />O.+nJ/Operator.��I <br />��/.J <br />�%�� <br />Title: <br />Address 1100 <br />E. Char <br />r Way <br />Phone: <br />Oa cr <br />(H 08 05 UGT 13 <br />Owner <br />464-6461 <br />SERVING <br />Ctty of Lodi <br />San Joe Quin county <br />City of Escaton <br />City of M.nt.c. <br />City of Ripon <br />Gly of Slockion <br />City of Tfacy <br />San Joaquin County <br />San Joaquin County <br />rye <br />FhV7RR 2 4 Ig8 <br />F�rRU� y <br />