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6 kf4oTOf MIUSTEES SAN JOAQUIN LOCAL HEALTH DISTR(j +SERVING <br /> 1.w...CW46.M664. ►..* VAy d fedi <br /> M-y Anaa t•••.Vkg tr., 40 1 Earl Hasaltan Av*nuo, P O. Boa 2009 9 j+equ County <br /> r*Grkfa E Y.w+wCt4,int r u"400quift County <br /> Twe"Mr Jere@ Stockton, Calllornia 95201 CRY 64 EACelon <br /> f.+1 1'IMnon101 CRY ed mentecd <br /> (209) 466-6781 My 0 NPOA <br /> .d.t L Fkwrr �h�i�ac+Kia' <br /> .raw q.U044.".a. ,fel Kbww%%KA.M PA..06Wkid ft"M 006CW ply al Tr"Y <br /> O«N a Kr.ham a"iMgrls C Pw tl <br /> UE - 1 3Z <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 , the undersigned owner and/or operator ofI the property and/or facility <br /> located at [L 51�L .]Toc Torn C,, SEALC <br /> hereby authorize L M K aal? <br /> to release Any and all analytical, results , geotechnical data and sit4 <br /> assessment information to the San Joaquin Local Itealth District as soon <br /> as it is available and at the tame time it is provided to one or my <br /> representative <br /> QwncriUptrrator WC3 —Ti tie. <br /> !G- <br /> y/ � <br /> A tl r i i • . . �v' O''� 3� l m C,> Wy . 1 110 n e. <br /> �AC-G CA 9spa i <br /> EH 08 05 UGT 13 <br />