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, v Jui,Uutiv r`LJI.HE HE1 Fi 1�I(,T <br /> larnel Cufbn <br /> e �on, f�Qa. SERV�No <br /> PANICl+ E. Vannucci, Sec-y- <br /> Anihonetle Van SpfOnaen 1601 East Hatelton Avenue. P. 0. Box Zoog Sen Joaquin County <br /> Ead Pfrnenfel StocktonCftyo[( sc+ton <br /> , Ca(I(ornia 95201 <br /> Fern ®upbee city Of Manteca <br /> Daniel L. Flofes 209/466-6781 City o}nl eca <br /> John D. Ma31, M.D. pon <br /> C;Ityof Stockton <br /> NIHIam J. Wade Jopl Khanna, M.f)_ City of Tracy <br /> Mary Anna Love f4t.F'.Ff., Ulslrlcl FEea}Eh t7fftcet <br /> San Joaquin County <br /> San Joaquin County <br /> AUTF40RIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA ANO <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or 'facility <br /> located at - <br /> hereby authorize , l ---------------- <br /> to release any and all analytical results , geotechnical data and site <br /> dssessment 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 /> representati ve_ <br /> Owne�/Operator: <br /> Title: � <br /> Address <br /> ti` 6 Phone_ - -0 <br /> Date: Q- 2C?_ <br /> i� <br /> 111 08 (6 11()T 13 <br /> -. -. rr <br />