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t <br /> FROM. 1 /04/88 1 9: 1 2 P . 2 <br /> �.801ielftq OF TRU8TEE8 SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> , At Crow,Pres. SERVING <br /> Earl Pirriontel,vice Pres. 1601 East Hazelton Avenue San Joaquin County <br /> Tommy Joyce,Soc'y. Stockton, California 95205 City of Manteca <br /> James F.Culbertson City of Escalon <br /> John D.Mast M.D. City of Lodi <br /> JOGt KHIINNA, M.a., M.P.H., DISTRICT HEALTH OFFICER City of Tracy <br /> Virginia Mathews <br /> Thomas Schubert,D.v.M. City of Ripon <br /> Daphne Shaw San Joaquin County <br /> Harvey Williams,Phe?. City of Stockton <br /> San Joaquin County <br /> t <br /> S <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA .AND <br /> SITE ASSESSMENT INFORMATION <br /> I . the undersigned owner anti/or operator of the property and/or facility <br /> located at IXAC r eD2160%5eAcrl ry <br /> hereby authorize r�� r �f��ec � <br /> to release any and all analytical, results, geotechnical data and site <br /> assessment information to the San 'Joaquin Local Health District as Boon <br /> as it is available and at the same time it is provided tome or my <br /> representative. <br /> ._SF�tIJL'�5, <br /> Owner/operator., Moe. 6A1 j e l te pee `I' Title; <br /> Address ij�� 0 IlO,- T-)4 7-A" 600L�//i9r�� Phone:�o9�S35- rSo� <br /> 7ZAcY <br /> Date; <br /> EH 23 041 3/86 <br /> Administration CNnlcet.°.9rv1Ce8 Environmental Hearth Public Health Nursing <br /> 488-3400 468-3830 468-3420 468-3860 <br /> Air Pollution Community Services Laboratory WIC <br /> 468.3470 468-3820 468-3460 468-3280 <br /> AIDS Information 468-3820 <br /> "TC)TAL P . 2 <br />