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It <br /> 0-1. 11 ........�.��. LV�.ML nc.h�r�riJrnt�.r SER\ <br /> Y lJsmas culbodson, Prss. city of <br /> 0.40 A n Low,Vke Pree. 1601 East Hazelton Avenue,P.O. Box 2009 San Joaquin 6 <br /> Patricia E Vannucd,8ady. San Joaquin C< <br /> Tommy Joycs Stockton, Callto"s 95201 of Cc <br /> Earl Pknsntsl city <br /> Vkpinla Math*" (209) 466-6781 CRY*(Mar <br /> Daniel L Fares ctty d F <br /> Boo* <br /> oh Sac <br /> S <br /> John D.Mash,M.D. Joel IQr.nna,M.D,M.P.H.Ois4kt M Oeso« - tel'of 7 <br /> Dena B.14alum San Joaquin Cc <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or o erator of the property and/or facility <br /> located at � r b Q,Lr) c K �/ V'Al <br /> Ck <br /> hereby authorize 4, ,Le kW'V, <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 . �nI p� '- <br /> l Owner/Operator: IVQ,IJav'- � . Akj otj Title: C)mTUy ul <br /> Address LUZVLc L (j�k phone: 944 -g2-7-I <br /> Date : <br /> E11 08 05 UGT 13 <br />