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. I <br /> l►oARo or rttusrEa:s SAN JOAQUIN LOCAL HEALTH IDR}CT <br /> Jams$ cobenson, Pres .. SERVING <br /> PaIrfcra E. vannuca. Ssc'y Gt; at Goal <br /> Anlhonalla von Sgsansgn 1601 East Haazeitolt Avenue, P. 0. $6X 2w) San Joaquin County <br /> Esel Pimentel 016 Eicalor+ <br /> Stockton. Cal ILornea 9+.011 <br /> Fern Supoes , Cliy al.rarnteCa <br /> OsnIN L. Flora 209/466-6781 C311 or fiipun <br /> John 0, ,.,last, M.Q City of Stockton <br /> I` <br /> William J. Weds 3;. Cli.r of Tracy <br /> Jopl Khannt, M,O., M.P.H.. 01,1,1Cl Hamlin 0111cer <br /> Mary 4nna Love San Joe14ufn County <br /> I San Joaquin County <br /> it <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECIMI�CAL DATA AND <br /> SITE C ASSESSMENT INFORMATION ; <br /> I' <br /> a I, the undersigned owner and/or operator of the property and/or facility <br /> is located at 23675 S. Airport Way Manteca, CA <br /> i; <br /> hereby authorize Canonie Environmental,- Stockton, CA 983-1340 <br /> to release any and all analytical results. geotechnical data and site <br /> assessment infornation to the San Joaquin Local Health District as soon <br /> 4s it is available and at the same time tt is provided to site or my <br /> representative. <br /> I ...., e <br /> Owner/Operator: ,J ,:. ,'; ' Title: ' ,. <br /> f. Address .� c�T� k ,� _Phone: � �cl� )c. L�+��� <br /> Date: — -7 '�► <br /> } <br /> li I <br /> ik <br /> II{[ <br /> I IIr 1 i <br />