Laserfiche WebLink
fkl`�;E Vannuccl, Secy; San Joaquin County <br /> Van:Spronsan 1601 East Hazelton.Avenue, P. O. 80x2009 City of E6uiw _,� <br /> r('Plinamat Stockton. Catllornia 95201 city of Mantaca. <br /> City of Rlpo�; <br /> 209/466-8781 City of StO'6 <br /> Cltyof a ' <br /> I»IsataM.D. <br /> 1 unJ Wade Jo01 Khanna, A1.D., lA.P.H., Olelricl Hoalth Otlicar San Joaquin County <br /> San Joaquin County <br /> fin a'Love <br /> ;i <br /> �f <br /> S<' <br /> 'AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> ITE ASSESSMENT INFORMATION <br /> �f <br /> the undersigned owner and/or operator of the property and/or facility <br /> y9�a ffA c -4,51& e <br /> _located atrl' _ <br /> hereby authorize 1 — <br /> �, geotechnical data an . <br /> k to' release any and all analytical results, dd site g r , . <br /> "assessment information to the San Joaquin Local Health District as soon <br /> r ' <br /> -is it is available and at the same time it is provided to me or my <br /> ,.representative. t <br /> k r. <br /> �Ir ; <br /> Otirne�/Operator: Title: <br /> 'Address Phone: <br /> yr�t, <br /> rt Date: <br /> YR <br /> v ' <br /> •5 <br /> Z .. M1)r Mi.n.r fir' m.-�+ri.+r^.✓•er�^N.�.-�'•�n�-r Y.�.»� <br /> , Fa✓G_�^+•. ..- e........r.,+.�-.....•..-y+.'+Ih�.w'n.... ..w..- ..e..._..waw. Y <br /> EH 08 OSy.:UGT 13 <br />