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sOAPJ OF 1RUSt EES <br />Jamas culOMson. Pr's. <br />Palrlcia E. Vannuocl. soc.l. <br />Anlhonullo Van Spronsan <br />Earl Plmantal <br />Farn eupbas <br />Daniel L Floras <br />John 0. Mast. M.O. <br />Wllllam J. Wada <br />Mary Anna Low <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />SERVING <br />1601 East Hazelton Avenue, P. O. Box 2009 San Joaa lin Cour yl <br />Stockton. Callfornia 95201 City of Escslon <br />2ii9/466 Biel City of Maniacs <br />City of Ripon <br />City of Stockton <br />Joel Khanna, M.D., M.P.H., Dlslact Health Offlcar City of Tracy <br />San Joaquin county <br />San Joaquin County <br />F9 It U <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND -SEP 2 8 1987 <br />SITE ASSESSMENT INFORMATION <br />� ENVIROMENTAL HEALTH <br />COrviLt�.twe l�LE�f/�n� ..��� FERMIT/SERVICES <br />I, the undersigned owner and/or operator of the property and/or facility <br />lncatpd At. f,� /; <br />hereby authorize <br />to release any and all analytical results• <br />te <br />dssessment information to the San Joaquin LocaelHealth lDistrictata dastsoon <br />as it is available and at the same time it is provided to me or my <br />representative. <br />Dwne�/Operajtor: �� / � <br />—=t Title: Tr/L <br />Address i3o,1- 5 9L Phone: Zoay_ 6�y-y�y <br />Date: <br />EH 08 OS UGT 13 <br />