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r, MUA#4- 01 1huslttI SAN JUAOUIN LOCAL 11LAL1II DISI Rl(,T SfP4VI No <br /> lamas Cu1Gerlson Pres Cltvof Lodl <br /> P8111cle E; Vannucc' SsC y San Joaquin County <br /> knihonatte Van spronsen 1601 East Hazelton Avenua. P © Box 2009 <br /> City at Escalan <br /> art pi nentel Stockton* Calltofnia 95201 City of Manteca <br /> 14% Buyoos 209/466.67$1 City of Ripon <br /> %.onlef l Flares City of Stockton <br /> john 0 Mast. M O City of Tracy <br /> Iillfam J Wade Joy[ Khanna. M 0 . M_P k . 01BI Eci Health Offlcer San Joaquin County <br /> '4ary Anna lore San Joaquin County <br /> s AUTHORILATION TO RELEASE ANALYTICAL R€SULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1. the undersigned owner and/or operator of the property acid/or facility <br /> located at <br /> hereby authorize <br /> to release any and all analytical results, geotechnical data and site <br /> ,?ssessment 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 nay <br /> representative. <br /> Owned/Operator: Title: <br /> Address Phone: <br /> Date: <br /> k� <br /> f <br /> �Ejj 08 QS UGT 13— <br /> — <br />