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e0ARD Of iRUSIEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> James Culuenson. P,ea. SERVING <br /> Pamela E. Vannuccl, Secy. City of Lodi <br /> Anlhonalle Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San JoaQuln County <br /> E a,i Pimenlei Stockton, California 95201 City of Escalon <br /> F•rn euDoee City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of Slocklon <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer City of Tracy <br /> Mary Anna Love San Joaquin County <br /> San Joaquin County <br /> AUTHORIZATION 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 7s7 In --AT- .n.Lr.d /YJNivrE ,q J'ao EctlF.cT cot ! Sr A4� <br /> hereby authorize ,f- <br /> to release any and all analytical results, geotechnical data and site <br /> dssesswnt information to the San Joaquin Local Health District as soon <br /> as it is available and at the salve time it is provided to me or my <br /> representative. <br /> Owner/Operator: E 1))X,,e7-/A.1 Title: t1l ��ce c_ <br /> Address �Q /fie < 9 Z ?'s7 hr, FvrJS[ad Phone: 6.2 3_ 3i g/ <br /> Date: .2-/ 3-97 <br /> ryI J <br /> FEB IS 1981 <br /> SAN JOAQUIN LOCAL <br /> HEALTH DISTRICT <br /> EH 08 05 UGT 13 <br />