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1 also, <br /> FOARD'Of MUST LES <br /> i's-as Cululbert eon, pros. SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> Patricia E. Vannuccl, Secy SERVING <br /> Anthonelle Van Sprnneen 1601 East Hazelton Avenue, P. 0. Box 2009 Sen City of <br /> County Earl Plmenlel <br /> Fern Bupuuu Stockton, Callfornia 95201 City of Escaion <br /> Daniel L. Flores 209/466-6781 City of Manteca <br /> John 0. Masi. M.D. City of Ripon <br /> William J. Wade City of Stockton <br /> Jopl Khanna, M.D., M.P.H.. District Health Dlflcer 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 <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 /> Title: > �}/1?�L< -L✓�.Z QJG2 <br /> Address/ <br /> Phone: <br /> 0 <br /> Date: <br /> ,f <br /> Gi✓ I �� lyoo <br /> ENVIRu:v t ,IAL hLALTH <br /> I ERMIT/SERVICES <br /> EH OR OS <br />