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Jeme1 CblLen son, Pres. ` SLRVING <br /> - <br /> (refulcle E. Vannuccl. Secy. ... City of Lodi <br /> Anihonall• Ven Spronsen 1601 East Hazellon Avenue, P. O. Box 2009 Sen Joaquin County <br /> zan Pimentel Stockton, California 95201 city of Escaton <br /> Fera suab" City of Menten <br /> 1anlef L. Florae 209/466.6781 City of Ripon <br /> John 0. Mast, M.O. City of Stockton <br /> William J. Wade Jogl Khanna, M.D.. M.P.H., District Health Otticer City of Tracy <br /> Mary Anne Love Sen Joaquin County <br /> San Joaquin County <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 X03 � (A 6A) <br /> hereby authorize _ CA�� CJ4 7- <br /> lf4e LRB <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. <br /> Owned/Operator: Title: AOCAJ, l_ic <br /> Address 70_ / % 00/ '4ye Phone: <br /> Date: <br /> EH 08 05 UGT 13 a <br />