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, <br /> 11(1Ali l)f T1It)5Ti.-{.,, SAI! JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> „f Jamaa Culhs+taon. Prea- City of Lodi <br /> Mary Anna Lova,vice Pres. 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> Petr{cis E.VannucCl,Set'y. San Joaquin County <br /> Tommy Joyce Stockton, Cailfornla 95201 City of Eecalon <br /> Earl Plmentef City of Manteca <br /> Vkpinia Mathews (209) 466-6781 City of Ripon <br /> Daniel L Flores City of Stockton <br /> John D,Mui,MI.D, Jogi Khanna,M.D.,M.P.H.,Disfrfct Health OMlcm City of Tracy <br /> Gene S.Kraham San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> tSITE ASSESSMENT INFORMATION <br /> ' I , the undersigned owner and/or operator of the property and/or facility <br /> I c� <br /> located at II <br /> hereby authorize <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 /> IM _ <br /> as it is available and at the same time it is provided to me or my <br /> representative . <br /> kG <br /> Uwrier/Operator : a / t�2 O_ 'I'i t 10 &Wi6YE — <br /> Ac[cl re!,:' -- ��L z}vr&L, ✓ --- -laitc�nc� : 1 y S g' <br /> � •, �3 S 533 <br /> L <br /> f <br /> f <br /> F <br /> I <br /> l <br /> 1 <br /> r <br /> Elf 08 05 Uc'r 1.3 <br />