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8nies ul Ytson. Pro SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> Jamas CulGertsor,, Pres. <br /> Patricia E. Iannuccl. Secy <br /> SERVING <br /> AntnonOtte Van Spronser 1601 East Hazalton Avenue, P. city of Lodi <br /> Earl P)mentei O. Box 2009 San Joaquin County <br /> Fern%Bugbee - Stockton, California 95201 City of Escalon <br /> DanJohn D. <br /> Florey 209/466-6781 City of Manteca <br /> John rn Mast, M.G City of Ripon <br /> William J. Wade City of Stockton <br /> Mary Anna Love Jogs Khanna, M.D., M.P.H., District Health Officer City of Tracy <br /> 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 /> - jE . 2cer, - A1w,0eN e7#. .4s�3� <br /> hereby authorize <br /> - C�1 ESrEa,� s P4-EMM- - S�i2v_LCE__. . <br /> to release any and alll analytical results , geotechnical data and site <br /> assessment information to the San Joaquin Local Health District ds soon <br /> as it is available and at the same time it is provided to me or my <br /> representative. <br /> Owner/Operator• <br /> Address � Title: <br /> G � '✓ 9 <br /> Phone: ��o <br /> 0 c <br /> EH 08 05 <br /> -.4 <br />