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Amhunnan van Solon,,, Ifx�_,151 H.vcllan A,unuo• p. O. 13oa 7(X) <br /> Cul Plmanlal Cn, nl l 001 <br /> F•on OopDaa Slocklon, California 95201 ..an Juavuln C4un,y 0anlal Eac•,on <br /> L. Flora CIIr of <br /> 209/4666781 Cfly of Manteca <br /> John 0. Maaf, M.O. Cot of Ripon <br /> William J. Wad• City of Slocklon <br /> Mary Ann. Lova Jopl Khanna, M.p.• M.P.N., Ofalrlcf Ilaallh 0(I1 <br /> c.r <br /> C14 of Tucy <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 s ] b0 Cflc/r� /(�E RA SToc/� 7o „i Ci9 952 <br /> hereby authorize rAn c),,v /E' ENrf SER /n�/ C Fv/c6- rrQi <br /> to release any and all analytical results, geotechnical data and siteV <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/Operator: „i,`Vr 7- w. �LiLLTitle: <br /> Address �70o C/�Eliof(�� RD Phone: ` O 93/-0co?v <br /> S%ocKro , c/Q c) <br /> Date: /yl A� 2 T <br /> i <br /> EH 08 05 UGT 13 <br />