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SERVIND <br /> sOAReor 111NS1EES SAN J&OUIN LOCAL HEALTH DISTRI* city of led, <br /> J'emsi Culbertson. Pres. Sen Josrtuln Cr.unlY <br /> Psbinls E. Vsnnueet. See'Y. 1601 East Hazelton Avenue, P. 0. 13011 ,009 City of Escelon <br /> Anlhonelte Ven Spronsen City of Msnlece <br /> Eeri Pimeniel Stockton, California 95201 city of nipon <br /> Fern Bupbee 209/466-6781 City of Stockton <br /> Denlef L. Floree city of Treey <br /> John D. Most. M.D. <br /> Jopl Khenne, M.D., M.P.H., District Health Officer Sen Joaquin County <br /> JVllllem J. Weds Sen Joequln County <br /> Mary Anne Love <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 /sd / aC /✓1? <br /> hereby authorize S v <br /> to release any and all analytical results, geotechnical data and' site <br /> dssessment infornletion 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 /> OwnAioperator: ,7 e Py C A r e S Title: g,Sst. FC« t ,'(74 <br /> Address / 4 6.r S. L- : coc"1 5/. <br /> Date: <br /> [H OO 05 UGT 13 , <br /> i <br />