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r004,140 OF TRUSTEES �' <br /> Jo -* Cdo.,teo„ P.ee .,AN JOAQUIN LOCAL HEALTH�,TRICT <br /> M Anne SERYING <br /> "r Lo",Vtce Pc... <br /> V.nm'cd. L.c'T. 1601 EastNecetton Avenue P.O. 80K 2009 Cey 0(Lodi <br /> I.Nc4 E. <br /> Tommy Joyce San Jopuln County <br /> Eee Plmeold . Stockton.California 95201 '.. se^JoeQuM County <br /> fie"•Meowwo a i City of Fxdon <br /> DsrAol L Fier" 466-tlltlt �._'�" ` ' t 't,'.� # city of Mentece <br /> :,y ` i CUy M Ripon <br /> i John O.Moet,M.D. � �1` Z �:';t ' <br /> Dene IL 10*ham Joel KheMy M-O�M.P.",OfetrlG NeeM ofacei\'JJ :a r:J Gly*(Stockton <br /> \. City y <br /> r; MTSK <br /> i \A0" f t1►Jopul^County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS GEOTECI{LAICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 'the undersigned owner and/or operator of the <br /> properCh c fa <br /> I@i. the <br /> I located at �/� 5 �46 lociz �G. <br /> � Ii <br /> hereby authorize <br /> t <br /> to release any and all analytical ----------results. data <br /> assessment information to the San Joaquin LocaleIfealthlDistrictdasisoon <br /> as it is available and at the same time it is provided to me or my <br /> representative, <br /> i� <br /> Owner/Operator: <br /> Address <br /> i.. i hone:��pQ} 944—SZSZ <br /> i <br /> i <br /> EH 08 OS UGT 13 <br /> i �yyyy <br />