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�F, <br /> ./RD of IAU51EEs SAN JOAOUIN LOCAL HEALTH DISTRICT <br /> ,fief CutGenson, Pres. SERVINo <br /> alrlcl■ E. Vannuccl, Secy, Clly of Lodi <br /> Anihonette Van Spionsen 1601 East Hazellon Avenue, P. O. Box 2009San Job <br /> ulnCounl <br /> J q y <br /> Gugba <br /> p, Ear! el Stockton, Callfornia 95201 City Of Eacalon <br /> Fern uflbee City of Manteca <br /> Daniel L. Florey 209/466-8781 City of Ripon <br /> John 0. Mail, M.D. City of Stockton <br /> William J. Wade Jogl Khanna. M.D.s M.P.H.. District Hesith cirricer City of Tracy <br /> Mary Anna hove San Joaquin County <br /> San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located at rS - l Al - / <br /> hereby authorize <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment 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 my ; <br /> representative. <br /> OwnJ/Operator: /X' , Title: <br /> Address Phone: G c/ p t10 y/ <br /> 7 <br /> Date: l— o - <br /> f ' <br /> E11 08 05 UGT 13 <br />