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AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />I, the undersigned owner and/or operator of the <br />Property and/or facility <br />located at /2 3 <br />c. -< 11V'7 SN T S <br />hereby authorize 5-7-iCN , _ <br />to release any and all analytical results, e <br />ch assessment information to the San JoaquinLocalHealthlDistricta a das'te Soon <br />as it is available and at the same time it is provided to me or my <br />representative. <br />Owner/Operator:-�i9�C,�s <br />/ /tom <br />Address — 1-2-3 E Title:y ail_ <br />Phone: y,C z <br />Date: 3 -_ _To .0 z <br />EH OR ns <br />L0 <br />BOARD OF TRUSTEES <br />James Culharteon, Pre.. <br />SAN JOAQUIN LOCAL HEALTH <br />Patricia E. Vannuccl, Secy <br />DISTRICT <br />Anlhonelle Van Spronaen <br />Earl Plmenlel <br />1601 East Hazelton Avenue, P. 0. Box 2009 <br />SERVING <br />Cllraf Lodi <br />Fern supouo <br />Stockton, California 95201 <br />_ San JoaQuin County <br />Daniel L. Florae <br />CRY of Escalon <br />John D. Mae1, M.D. <br />209/466-6781 <br />CITY of Manteca <br />William J. Wade <br />CITY of Ripon <br />Mary Anna Love <br />Jopl Khanna, M,D„M,P,M„ District Health Officer <br />Cltyof Stockton <br />City of Tracy <br />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 <br />Property and/or facility <br />located at /2 3 <br />c. -< 11V'7 SN T S <br />hereby authorize 5-7-iCN , _ <br />to release any and all analytical results, e <br />ch assessment information to the San JoaquinLocalHealthlDistricta a das'te Soon <br />as it is available and at the same time it is provided to me or my <br />representative. <br />Owner/Operator:-�i9�C,�s <br />/ /tom <br />Address — 1-2-3 E Title:y ail_ <br />Phone: y,C z <br />Date: 3 -_ _To .0 z <br />EH OR ns <br />