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60AAD O( IRUSI((S • <br /> J.m.. cou.n.on. P,... SAN JOAQUIN LOCAL HEALTti DISTRICT <br /> P.I,Ic1. (. v.nn-ccl. s.c'r SERVINO <br /> Anlhonalfa van So.on... IG01 East flaicllon Avenue, P. O. Bot 2009 Cl (odl <br /> E.,I Plmanlal San JoapulnC County <br /> F.,n RopUa. Stockton. California 95201 Cllr of E%colon <br /> Daniel L. Flora. 209/466-6781 City of Maniac. <br /> John 0, Mail, M.O. City of Ripon <br /> William J. Wade City of Stockton <br /> Jopl KAanna, M.O., M.P,H., District Health officer City of Tracy <br /> Mary Anna Lor• San Joaquin County <br /> San JOAQuln County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 , the undersigned owner and/or operator of the property and/or facility <br /> located at p ,/ <br /> lk.,'Z <br /> hereby authorize ' <br /> _ .�L�t� <br /> to release any and all ana ytical 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 /> OwneWperator: <br /> mac_ Title: <br /> Address �Z � <br /> � Phone: <br /> DEC 3 198b <br /> ENVIROMENTAL HEALTH <br /> PERMIT/SERVICES <br /> if on nc nrT Il <br />