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4„4+ JVAVU61% LQ%,AL HtALIH L IHit-l -- <br /> 14-7 AM.L«. vk.►'« SERyiNG, <br /> ►.NcL.N.nm,ed, 1601 East Ha[alton Avonu., P.O.Boat Zoog Qri o(Lod” <br /> 1. .«y. <br /> ff��oi slocmon,California 9S201 6itJ"quk cw <br /> E r <br /> vvtbvd mov"W. c11r N Eie.bn <br /> 04rM L.f1.n. (209) 466.6/61 'Ctr.M w.nt.ca <br /> CRY of R4"A <br /> JAM 0.Ma.e,a10. aatRn.�y rt o.M!!1,01rNd N..M flue., C"y of Su kten <br /> O.n.l R'r.N.w - <br /> CRY 01 Tracy <br /> _ _.. . a"�w4uln C.�nb <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 <br /> 1 , the undersigned Owner and/or Pp rator of the property and/or facilit <br /> located at t <br /> ,' I �iP"1 <br /> hereby authorize VV �'� L <br /> to release any and all aaaiytical results <br /> r, geotechnical data and st'Cti <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 /> Owner/Operator: <br /> c- � <br /> Title r <br /> Address � h <br /> 11 G o�"l O <br /> Oate . <br /> I <br /> " <br /> EH OB 05 UGT 13 <br /> .. ... ar ���_....�...._... _.J3m.a.;.. . .vl�uF.•*tM+s".�. Win;, . . . . .." 1I::k..a....,.. <br />