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,+ OAN P tRUSIL'tS ± HI IUEIV i~Vk-.HL 1-1t_rAt_ I i t vi•� cnv�nu <br /> y,Cutbortson. Pros. City'of Lodi <br /> a rir�a'E Vannuccl, Sac'y. San Joaquin Count <br /> .. w. 1601 East Hazetton Avenue, P. O. Box 2009 y <br /> honatIi Van Spronsen City of Escaion' w; <br /> �art"Pimento$ Stocklon, Callfornia 95201 i City of manteda' ' <br /> x'.J#un supdee <br /> 209/466-6781 City of Ripon <br /> rXiniei L TIO:ras City of Stockton <br /> ' I'Jonn D:Mast. M.D. City of Tracy .' <br /> "Wttflarh V. Wada Jog[ Khanna, A4.i}.. M.P.H., Dfatrlct r{eaith Officer San Joaquin County <br /> Miry Anni Loye San Joaquin County, <br /> if <br /> ` 4AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AICD <br /> SITE ASSESSMENT INFORMATION <br /> T; <br /> the undersigned owner and/or operator of the property and/or facility <br /> ,=4yr�''16ca_ted at b <br /> .. � <br /> b'. authorize here a L <br /> lease any and all analytical results, geotechnical data and site <br /> assessment information to the. San Joaquin Local Health District as soon <br /> --t: is available and at the same time it is provided to me or my <br /> represerttati ve. <br /> }{r yy11 <br /> k;--M-"{-'Owned/0perator• - ',(vJJn` Title: <br /> h..� , <br /> ' Address y',ko Phone: /�— o G d c� <br /> " Date` Y3 <br /> 4�> <br /> m <br /> _ ..I.'��,,:;L.r.Lt��sJ-1r6{�!•���+Sl?i_:r..:Trt7�• •.:f.+ .,..ha, s 2%:Tf^�'.!!i',37:.'bl'7;!i11:ti,Ct`.�,"v'CC+"-g� 3:-i-'=-4.. .-.-.r.., �.. --,..r.,r...._m=.p�� ..-� ,Y....�-.L., <br />