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Ono or n+ustLLs <br />J-03 culbar,aon, Pre,. SAN JOAQUIN LOCAL HEALTH ( 'if 2 5981 <br />PaVIUe fl. vannurcl, soc'y I'I�LTH "I NVINu <br />Anlhonelte Vari Spronaan 1601 East Hazelton Avenue, P. O. f3o>E,WVf OMENTAL Illy „f t,,,tl <br />Eon Plmmntnl RVICES, san Jp, <br />Stockton, California 95201 FEWIT/SE qwn cnnnly <br />fern l L. ben city of Elcaion <br />Daniel L. (lore! 209/466-6781 Cllyol Manlnce <br />John 0. Mall, M.D. City of Ripon <br />William J. Wade City or Stockton <br />Mary Anne Love Jopl Khanna, M.o., M.P.H., District Health Officer City of Tracy <br />San Joaquin County <br />SanJoaquln Cuunty <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />I, the undersigned owner and/or operator Dirge property and/or facility <br />located at _LA rtru'g <br />hereby authorize C 42st F r r 1.A r s o 1 <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 />04ner/Operator:� <br />Address /-- .t�Title <br />iC/NrJS� S7 Phone <br /><1as z <br />Udte: <br />€H on n5 <br />