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ao^tin or V V11EES SAN AQUIN LOCAL HEALTH DISTR f <br /> James .'.uib*nson, Pres, SERVING <br /> rat;tcta E. Vannucd. Secy. Gty of Lodi <br /> Anlhonatle Van sproneen 1601 East Hazelton Avenue, P. O. Box 2009 son Joaquin County <br /> End B'Imenfef Stockton. Calllornia 95201 CGtYof Eacaton <br /> Fain eupbee CllYof Maniacs <br /> Danlef L Floras 209/466-8781 Ott,of Ripon <br /> John D. Mut. M.D. City of Stockton <br /> WWttam J.Wada Joel Khanna, M.o., M.P.H.. Dfatdct Health Officer Clty of Tracy <br /> Mary Anna low San Joaquin County <br /> San Joaquin County <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 at a/ GJ Q CC) <br /> hereby authorizes P <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 Sarna time it is provided to me or my <br /> representative. <br /> Owned/OperiLtor. Q.�)_. 1-)_,,2 ,J Title: <br /> Address Sal W. Phone: <br /> Date: <br /> H 08 05 UGT 13 <br />