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80AA6 Of IAUSICLS �- <br /> J■inai Curberlson, Pros, 5L13Vtav4 <br /> P&MCIA C. Vannuccl. SeC y. City of Lodi <br /> Anihonetle Van Spionsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquln County <br /> Earl Plmentel Stockton. Callfornia 95201 CIly of Eicnion <br /> Fern Bugbee Cllyalmantece <br /> Daniel L. Flores 209/466$781 City of Ripon <br /> John D, Mast, M.D. <br /> City of Stot:kton <br /> William J. WadeCity'of Tracy <br /> Jopl Khanna, M.D.. M.P.H.. Dlairlcl HealthGfrlcer San Joaquin County <br /> Mary Anna Love San Joaquin Counly <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND'r <br /> SITE ASSESSMENT INFORMATION <br /> I, the undersigned owner. and/or operator of the property and/or facili'ty <br /> located at r p G <br /> hereby authorizeNly1 G c c <br /> to release any and all analytical restarts, geotechnical data and site . 1 <br /> dssessment information to the Sari Joaquin Local Health Districts as soon'- <br /> as <br /> oonas it i; available and at the same time it is provided to me or my <br /> representative. <br /> 1 <br /> OKn� erator: Title: <br /> Address — — Phone: a?oY y(L3_.�F6G <br /> r, <br />