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:`max e';ulbarl aon, Pies. City of Lodl <br /> Pelrlcla._E' rL nuccl. ooc'y, - Joa San uln Cou nl <br /> Anthonotla Van Sp(onsan 16 st Ha2elton Avenue, P. O. Box 2009 q <br /> „ � Ne CIIY of Lac Dionn <br /> Earl Plmenfal /-l' Stockton, California 95201 �A-) <br /> Parn f3Upoea Clly Mantecaof Ripon <br /> Danlol l_ Floras 209/466.8791� Cityy oofyf Stockton <br /> John D. Mast, M.D. <br /> Clly of Tracy <br /> Wllllnn .1. Wade J001 Khanna, M,0., IIA.P.H., Dinlrict Honilh Officer San Joaquin County ,yy <br /> Mnry Anna Love Son Joaquin County <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 LC'/2r <br /> hereby authorize <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment 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 /> Owner/Operator: '/�'on e Title: lt�A c•r <br /> Address Z�10 y /- Phone: �% i j' <br /> Date: 4 / 4 <br /> i <br /> N%bV r 19& <br /> E � H LLTH\ (Az <br /> 5 <br /> EH 03 05 UGT 13 <br />