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NO <br /> �' - <br /> .� -3. x�.nr K t .ry, i+ ,•v ,,fit. y "J <br /> i <br /> fpU5rEE3 �SA14 JOAQUIN LOCAL HCAI_TH )ST111CT <br /> ..n.•.,,r..,, SERV1}aC <br /> j°t"•' •rr... IGo I Eeet Iteieilon Avenue,P.O. 17o11 2007 �r ea t.df <br /> G Ya�nucct,L+t'r. S•n!e•yrin Can1r <br /> �rJ.rc• Stockton,Cnlltornln 05I01 Sen)"ROnGrxnlr <br /> Val h Mau"-, tl t et C•{a ton <br /> +f L/ler►• Goal ,ra•nra t r ei M,nlet• <br /> Gkr of n1v�+ <br /> O.na 0.Kr�h�m lsgl Kh.n 1 u.n,14'r,11,VI.WC1 f I••fei Ot~c.. Gtr•d jr►cr <br /> �� 6.n Jwr1�M Cae�nh( <br /> i. <br /> y <br /> ti <br /> AUI'li0[I1ZATION TO RELEASE ANALYTICAL RESULTS, GE0TrC1tt{k'CAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undernigned owncr And/or Operator of the property and/or facility <br /> located at ' i; e? <br /> ;Icrcby authorize ��` �` <br /> to rciease any and all Analytical results, geotechnical, data and siti <br /> assessment information to the San Joaquin Local Ilealth District as soon <br /> as it is available and at the same time it is'providcd to me or. my <br /> representative. <br /> Owner/Operator: "3D�l ' <br /> --Title: [-�_�( <br /> Addreas [�j�� � �� <br /> Phone: �Qc <br /> Date: <br /> t <br /> 4:• <br /> i I, � r� • lir <br /> ��3: .r .++:f� ilr.l.��+�i�lfl�t �i � .�i�.R• 1 +�,���{1rf�'i�,�. <br />