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.+*.' 2011no '-- "'YV <br /> San Joaquin Cot <br /> "John D. Mast, M.D. JOQI Khanna, M.D., M.P.H.. District He^Ith Ofllcef San Joaquin Col <br /> William J. Wade y <br /> Mary Anna Love �- <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 /> 521 NORTH.CHEROKEE LANE LODI, CA 95240 <br /> hereby authorize RAMCON 1450• HARBOR BLVD, W. SAC CA 95691 <br /> to releaseany 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 /> „� Title: <br /> Owner/9per4ter: / Phone: 3 <br /> Address �� " <br /> Date: <br /> ENFERMIT/SERV <br /> PERMIT/SERVICES <br /> EH 08 05 <br /> i <br />