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R.., - - 'y'hV810 - Y <br /> Immum <br /> Ile V*A Sjwan.•n 1601 f ail 11-W luil Avcrluo, Ir. Q. fill, 71►IJ9 �'I•MlaeI <br /> ■n Jo•gwln G4+amy <br /> . 'irYgnial Slockfon, city <br /> if 01 <br /> :,�sug13•• California 95201 r ic•lan <br /> `-Alai L. f loses 2D9/466.6181 Cllr o!Maniac, <br /> 0. M,i1, m 0. Cilrofalpon <br /> n city o!SlocLlan <br /> ,+1►liora J. Y1+e9a Jup!Kh•nn• Id,p„ yq,A,H., Dlablcl!f•allh Qrllcet City Al 114c} <br /> i•/1 Anne Lo.• Sea Joapuln Cmunlr <br /> S.n Ja•fluln�nlr <br /> AUTNORIZAII®li TO RELEASE ANALYTICAL RESULTS. GEDIECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMAIION <br /> ,y i, the undersigned owner and/or operator of the Property and/or facility <br /> located at27 <br /> hereby authorize C <br /> r W release any and all analytical results. geotechnical data and site <br /> r_.,dssesxayent information to the San Joaquin Local Health District as soon <br /> s itis available and at the same tine it is provided to m. ar my <br /> representative. <br /> 6P, <br /> Own6/Operator: <br /> Z? Title: <br /> AddressJO <br /> �- !'hone: <br /> `15Date: Pj,2 <br /> 3 '/ <br /> w■ e . <br /> H 08 OS UGI 13 <br />