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.Deno o$' .non. <br /> J.maa t.ull) p,,,. SAN JO%UIN LOCAL HEALTH OISTRIC10 <br /> MwnPu <br /> alulcle E. vannuccl. Sac'r Ctly of SLRVINo <br /> INO <br /> nthonel$e van Soron,.n 1601 East Hazellon Avenue, P. 0. Boa 2009 San Joe Quin Coumy <br /> B <br /> t.Odi <br /> •rnup D.• <br /> ar$ lmenlel Stockton. Calllofnia 95201 City of Esceion <br /> ante$ L. Floras 209/466-6781 City of Manl.c. <br /> City of Rlpon <br /> ohn D. Mast, M.D. City of Stockton <br /> Illlam J. Wade Jopl Khanna, M.O., M.P.H., Ofaldtct Health Otllcer City of Tracy <br /> ary Anna Love San Joaquin County <br /> San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/*r-o{eSatw of the property <br /> located at � 3 �oj '50 V ions /Z <br /> hereby authorize <br /> to release any and all analytical results. geotechnical da a and site <br /> assessment information 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 /> Owned/Operator: <br /> �. Title: n UiV�jz <br /> Address / / 6Sj �„-y i✓,a✓ . ap Phone: �pc� XSk_Z 0 <br /> A EiH cA 0-3 <br /> P <br /> H 08 05 UGI 13 <br />