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EJAHO OF.THUSTEES <br /> `SAN JOAOUIN LOCAL HEALTH LTRICT <br /> SERy1MG <br /> r,tAc4 E.V.enucN,ory Ann.Low,ve4. r,C.c'r«. 1601 Eoxl MaLohon Avenue. P.O. Box 2009 CHI of Lodi <br /> T. y Jere. SAO Joaquin county <br /> fed rlm.n t Stockton. California 95201 S.n Joaquin County <br /> VIrVkAd M.tMvn City of Fx.lon <br /> p„"L fbroe (209) 466-6761 city of M.nt.cx <br /> Join O.M cHr of Ali o <br /> N(,M.O. <br /> O.n.a KrM.n, Jo-0KA.nnti w <br /> MA.M-PA.D6Md Mth Omcw is CHy of Stockton <br /> CHy of Tr" <br /> -- Son Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 71 1 , the undersigned owner and/or operator of the property and/or facility <br /> located at ��.y/�N✓ <br /> hereby authorize u' <br /> to release any and all analytical re ults, <br /> assessment information to the San Joaquin Local e!{ealthlDistrict data dasisoon <br /> as it is available and at the same time it is provided to me or my <br /> representative . <br /> Owner/Operator; <br /> Title: `f �e <br /> nt�e BC9/P_5Ld 5� iU <br /> n I'll On <br /> l': Z/3' �97 �Q CjJ <br /> _7_ <br /> 4U,/fl;D <br /> JL 0 /T/V 9 L/ef, �f/ 9,, S <br /> Date : <br /> vN���10 <br /> ' EH 08 os UGT 13 <br />