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t ' <br /> avARD Of la stFts SAN JOAOUIN LOCAL HEALTH DISI WCT <br /> S[RVINO <br /> 12&mas Cult)en3on, F'sn3. <br /> Patricia E. Vannuccl, SecClly of[odly. Count San Joa uln <br /> Anthonette Van Swonsen 1601 East Hazelton00 <br /> Avenue, P. O. Box 29 q y <br /> scelon <br /> Earl Pimentel Stockton. California 95201 City f Emacs <br /> Fern Bupbee City o!Manteca <br /> Daniel u Flores 209/466-6781 City of Ripon <br /> City of Stockton <br /> Cit <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.N., District Health Officer San Joaquin County <br /> Mary Anna Love <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 PE f <br /> hereby authorize ®wss <br /> to release any and all analytical results, geotechnical data and site <br /> assessment info tion 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 /> JOLs1 vc v0«a.m, <br /> a -- <br /> Owne /Operator: _ 1 't - . Title: .v v® ., ty. C a. , <br /> Address o4,4i&bjad=Q Phone: <br /> Date: <br /> e - <br /> EH <br /> 08 05 UGT 13 <br /> 9 <br />