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eaarJ OF )RUST EES <br /> n <br /> 'amSAN JOAQUIN LOCAL HEALTH DISTRICT <br /> Culutpanson, Nes. <br /> Palflcla E. vannuecl, Secy. City of Lodi <br /> Anthonells van Spfonaen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaduln County <br /> Earl Pimeagb lel <br /> llu <br /> Fern BuQON Stockton, California 95201 Clly of Escalon <br /> City of Maniac, <br /> Daniel L Flores 209/4%-6781 City of Alpon <br /> John D, Mast, M.D. City of Stockton <br /> William J. Wade Jopl Khanna, M.O., M.P.H., Dlatrlct Health Officer city of Tracy <br /> Mary Anna Low San Joaquin County <br /> 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 /> located at �2 E 6efi rci vim {7e <br /> hereby authorize ui� .n rrrr>Fi�c GU t3or K172 rkE2-" 08 937//0 <br /> to release any and all analytical results, geotechnical data and site <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 /> Owned/Oper�Ltor;�Z �� �tic–� <br /> — Title: �vx ���•�.a-� ,s% <br /> Address /%C/ �«� Phone: (-"E as) 5,1 S &- <br /> Date: <br /> EH 08 OS UGT 13 r <br />