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b URHp DI THUS It t SA*AOUIN LOCAL IILALIli [AS 10�I S(,AVIN o <br /> Juner CWbeflfOn, Pref. <br /> Joaquin Count <br /> C11 of Lodl <br /> PalficiAnlhoa E. Venn uccl, SeC'y. San Joa <br /> Anlhonelle Van Spron,en 1601 Last Hazelton Avenue, P. O. Box 20(19 q r <br /> City of Escalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fun BL. <br /> Daniel L. Floras 209/466-6781 city of Ripon <br /> City Stockton <br /> John D. MsfM&311. Citt, M.D. y of Tracy <br /> William J. Weds Jopi Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Lova Sen 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 roperty and/or facility <br /> located at / G <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 /> Ownef/Operator• Title: <br /> Address Phone: <br /> Date: <br /> a <br /> EH 08 05 UGT 13 <br />