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James Culbertson,Pres. -)VAVUnv t.uGAL HEALTh-bISTRICT <br /> Mary Anna Low,vice Prp. SERVII <br /> Pabkia E.Vannuccl,Secy. 1601 Fast Hazelton Avenue,P.O.Boz 2009 CRY Of L <br /> Tommy Joyce San Joaquin Cou <br /> Earl Pimentel Stockton, California 95201 San Joaquin Cou <br /> Virginia Mathews City of Esco <br /> Daniel L floret (209)466-6781 . City of Mank <br /> John D.Mast,M.D. - City of Rip <br /> Gene S.Kraham Jogi Khanna,M.D.,M.P.R,.of h"i OMter City of Stocks <br /> .. City of Tra <br /> San Joaquin Cour <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner a"/or operator of the property aid/or facility <br /> located at 5�o <br /> hereby authorize <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 /> Owner/Operator: <br /> Address /SDS �� Aye Title: iioQd6] , y <br /> n-- l2Si[ .� CY 3 219r Phone: <br /> ry <br /> Date: <br /> EH 23 041 3/86 <br /> EH <br />