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� I I <br /> i A-xv e rc <br /> r' ji <br /> JOAAO Of IAVSTEES SAN JOAQUIN LOCA HEALTH DISTRICT si sevrHa <br /> James CulbarlsOn. Pros �f C11- of Lodi <br /> jPaR1Cta E. VannuCcl, Secy - San Joaquin County <br /> nlhonalt. van so'on3an 1601 X351 tiaze11Q11 Avenue, P b. Sax ��`� <br /> � <br /> � City of E,caion <br /> Earl PlmanISI Slorklon, CaMornfil 91+:01 �j C1iy ofµanlnC6 <br /> ferA Su ove I` CU-1of(upon <br /> 1 209/466-6781 <br /> Oanlel L. <br /> Florsj # City of Stockton <br /> John 0. Mall. M.O. 3 City of Tracy <br /> Wtlliem J. Weds Jogi Khannt, M.O., )A,P.H., District Hashn J11tcOr Sion Jost,uln County <br /> MWY 14AAA trove 't San Jusquin Cuun:y <br /> iy <br /> f I� <br /> S. I? <br /> AUTHORIZATION TO RELEASE ANAO TICAL RESULTS , GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION ik <br /> f <br /> I, the undersigned owner and/or operator of the property and/or :,faciIity <br /> located at 23675 S. Airport Way, Manteca, CA <br /> hereby authorize ;'anonie Environmental, Stockton, CA 963=X1.340 _ <br /> --- ;i <br /> to release any and all analytical results , geotiacnnical data and site <br /> assessment infor-ration to the San Joaquin Lccal Health District as soon <br /> as it is available and at the same time it .is provided to me or ,my <br /> representative. i! <br /> iY <br /> Owner/Operator: 'r, r u [, Title: <br /> Address K Phone: j <br /> Date: <br /> if <br /> ii <br /> �3 <br /> 13 , <br /> . 4 <br /> if <br /> 3k <br /> i, <br /> I� 1 <br /> i` <br />