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' tJU %\AVw% w�,HL IIL'AL"crt 'UtJ r . _ SEflY1NG _ <br /> wi.�r'A-4 tore.v%eo Fee . East Haction Avem* P.O.Bell 200 clgr+.lLod' <br /> ►04#1014 E:YMwred,Leer, ' . ,�M JwqulA#.'ou�ty <br /> Jo" Stockton.Callfaws 95201 <br /> E4A rMw«�la ahW96"maviews <br /> �f':Eiedo" <br /> O,kf.Id L flare (209 EQS-ti�tl l Cllr l R1po" <br /> "M 0.M444.MA. Cky of z4odcw <br /> I4g1t�tN.l�MA,M.Pdt.•ObYlol Ii44Nh 011e« <br /> c1q.4/Twy <br /> .. ,ti4q iepuM.�ouetr <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> the undersigned owaer and/or operator of the property and/or facility <br /> - y <br /> located a t4. <br /> /�D ,ala`�✓ f�- Sc /c�,� �,�1 <br /> hereby authorize ?-<S �,[�" �/�'©,c�,Lf(�cJ � f <br /> to release any and all analytical results. geotechnical �ataiand site <br /> assessment information to the San Joaquin Local Health District as soon <br /> k <br /> as it is available and at the same time it is provided to me or my <br /> representative. <br /> Owncr/ O erator: l%G /PR <br /> Date . <br /> I <br /> I <br /> f <br /> EH 08 05 UGT 13 <br />