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James Cult)nrtaon, P(oa. r City of Lodi <br /> r. Vannuccf, :roc*y <br /> - <br /> r nllaannf10 Van SG>ron�e,n 1601 C-a t Ha;-Felt n �vf;fftao, P, 0. �1��'�0d9 San Joaquin County <br /> furl Pimtsn9al e City of raColoa <br /> ,1,tcacMun. G allfo ria 95201 City of Mantoca <br /> fi�nr3f !_. : lama ?Ol.�ik�- 7tI� City of Ripon <br /> Clty of Stockton <br /> John D. Mont. M.D. City of Trncy <br /> V11111amr J. I"Indo Jo0l Khonna, t>7 P..:,L, Motrlct Hoalth Officcir <br /> Snn.foaculn County <br /> Mry Anna Bova S-in Joaquin County <br /> AUT110RIl_ATION TO RELEASE ANALYTICAL RESI.LTSr, CE0TECHNICAL DATA AND <br /> SITE !S7ESSKENT INFORMATION <br /> 1 , the undersigned ovaner and/m. operalmr of the proporty anti'/or facility <br /> located at �10K1 �—.1�'`i Ste° s ©o sraa 1 f1 S7�1� .✓ <br /> hereby authorize ,_� _f! c•x ,¢ - <br /> to release any and all analyti.rr.l resiAltF,-. :SIaeotechnical data and site <br /> dssessment information to till' Earl doil(1041 14J'cal Health District as soon <br /> o t as it is available and at the S'ame time is provided to me or my <br /> representative. <br /> Owner/Operator- ' ''�'"�'' Title: <br /> Address S o 11v+ Phone: l <br /> Date: <br /> APR <br /> ENViRUME�,JAL HEALTH <br /> F ERMIT/SERVICES <br /> E!-I 08 05 UGT 13 <br />