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SA40AUUIN L(-)(-:AL 11LAL 1 li UIS4(_l SLRVINO <br /> . son. f` nf <br /> V.nnuccl, Sac'r Cllr ollodl <br /> Anthonalle van Spronsen 1601 East Hazelton Avenue, P. 0. Boa 2009 Sen JoaQuln County <br /> Earl Pimenlel Stockton, Callfornia 95201 City of Escelon <br /> Fern Bugo" City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Meet. M.D. City of Stockton <br /> William J. Wade Jopi Khanna, M.D., M.P.H., District Health Officer City of Tracy <br /> Mary Anna Love 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 property and/or facility <br /> located at <br /> hereby authorize t -, <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 /> r <br /> Owned/Operator: a�_,�.�� ��-w /= Title: <br /> Address LC Phone: Vic`;- 3G f 7 /9y <br /> Date: S <br /> EH 08 05 UGT 13 e <br />