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uw UULtfEL SAN IAQUIN LOCAL HEALTH DISTf T 4LDy�S. (/�wKfft^E, <br /> •, C!tt0ana°n. Pigs. —, SERVIHO <br /> .4rrcla T. Vannrod, Sally. �,,?/ <br /> Earl 9ftM Van Spon"n 1601 East Hazelton Avenue, P. O. Box 2009 K�`� �`saA Joy;,l�°qty <br /> Fan, swab" Stockton. California 95201 City of Escalon <br /> Dania$L Flow„ 209/466-6781 city of Manteca <br /> J0" 0. Mast, M.D. City of Ripon <br /> Wm4w J.Wade Cily of Stockton <br /> Mary Anna Low Jog' Khanna. M-D„ M.P.H., District Health Officer City of Tracy <br /> San Joaquin County <br /> San 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 <br /> hereby authorize Bc ww�bc rs <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 /> Owned/Oper4tor:,� L <br /> Address Title: C k <br /> Phone: <br /> Date: <br /> 1988 <br /> ENVIROMENTAL HEALTH <br /> FERMIT/SERVICES <br /> I <br /> t <br /> EH 08 05 UGT 13 <br /> i <br />