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ver <br /> BOAR <br /> AM63 of IN ,,. pla SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> hmea Culben son, Pres. <br /> Patricia E. Vannuccl, SeC'y SERVING <br /> Anthonelle Van Spron,en 1601 East Hazelton Avenue, P. O. Box 2009 S.n Jo. city of Lodi <br /> Earl Plmenfoi Joaquin County <br /> Fern eupuuu Stockton. California 95201 City of Escalon <br /> Daniel L. Flores 209/466-6781 City of Manteca <br /> John D. Mast, M.D. City of Ripon <br /> William J. Wade Jopl KhannaCity of Stockton <br /> Mary Anna Love , M,p„ M.P.M., DIelrlci Health Officer City of Tracy <br /> San JOiquln 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 90U 1// CA L (J <br /> Lo release any and all analytical results, geotechnical data and site k-, L 135 <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. Title: QCJ/� L <br /> Address lbZb - Phone: /moo 17 � <br /> Date: <br /> ru no nc <br />