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3 OF 3 <br /> o.Ao or lRuslcts SAN JOAQUIN LOCAL. HEALTH DISTRICT <br /> SCRVINO <br /> .mu culb.n.on. f... <br /> .1110. L. V.nnuccl. S.c'y City of loll <br /> 1601 East Hazelton Avenue, P. O. Box 2(X19 s•^Jo.gQln County <br /> nthonatte Ven SplOna.n <br /> city of E auton <br /> .,I Plm.ntel Stockton. Callfornia 95201 Cliff Of Manteca <br /> „n ouobe. 209/466-6781 City of Ripon <br /> .,lei L. f lo..a city of Stockton <br /> .hn 0. Mari. M . City of Ttacy <br /> Illlam J. Wade Jog$ Khanna. M.D.. M.P.H.. District Health Offlcv San Joaquin County <br /> .ry Anna love San Joaquin 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 L <br /> located at /55-D <br /> hereby authorize <br /> to release any and all analytical results. geotechnical data and site <br /> assessinent 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. , l <br /> isOwner/Operator. C �� � Title: r�npr- <br /> Address /asp s iallsJ fed Phone: �,y -2-4y 0a/ <br /> 11 LC : <br />