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ronr.D OF rru -,.:cs Siad JO",(?lJiiV 1"OC,11, I1;.:/ LT I ilP4"I"f;l(;T <br /> Jcmes Culbcrtsc•i. Pres. CI;y rf Lodi <br /> Patricia E. Vr.nnuecl, Secy. en Jo--;aln County <br /> Anthonette W n Spronson <br /> 1601 East Ilezelton Avcnuo, I . O. Cox 2009 City of f-scLion <br /> Earl Pimentel Stockton, California 95201 City of Manteca <br /> City <br /> Fern Bugbee 209/466-6781 on <br /> Daniel L. Flores City of Stockton <br /> John D. Mast. M.D. City of Tracy <br /> William J. Wade Jog! Khanna, M.D., M.P.W. District Heath Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> 1r5 ` a <br /> located at <br /> hereby authorize <br /> to release any and all anal 'cal results, geotechnical data and site <br /> assessment information to the San Joaquin Local Health District as soon <br /> as it is available ;nd at the same time it is provided to me or my <br /> representative. <br /> Owner/Operator: �� �z-ss��l� Title: �oirJ- <br /> Addresshone: meq— <br /> Date: <br /> EH 08 05 <br />