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aOAAP OF TAU67&[S JOAOUINL <br /> James DutDartaon, Pres. <br /> peCrTCia G. Vannvect, 84 °'y• 1801 Feet hazalton Avanve, P. O. Box 2t`. CI <br /> Anthonatta Van SWOnesn <br /> !an Plmantol Stockton, California 952F cityCity of Manuo <br /> Fern 0utibes 209/4 8781 city of <br /> oktan q <br /> DanlalL. flora Cltyof of <br /> John 0. Most, M,D. City of Treey'.f <br /> William J. Wada Juel Khanna, M.D., M.P.H., Dbltlot Haalth Of icor San Joaquin County,; <br /> Mary Anna Lova San insquln County <br /> r,r <br /> J. <br /> .t. <br /> AUT!i+'..t - 4TION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND ' <br /> SITE ASSESSMENT INFORMATION <br /> LI}�; <br /> I, the undersigned owner and/or operator of the property and/or facility, <br /> located at <br /> hereby authorize <br /> to release any and all analvtical results, geotechnical data and site 1' <br /> assessment informatics, * ; the San Joaquin local Health District as soon <br /> as it is availablthe same time it is provided to me or ty <br /> t> <br /> representative. <br /> :n4 !Operator: — Title: ARDO— C <br /> PO (3oY __ Phone., -S"71_�y <br /> 5 ��n C? _ <br /> Dates <br /> SEP �sas <br /> ENFRC)mENSERV CESTH <br /> Arrs7vT70ty /1,e <br /> EH OS 0� <br /> • c <br />