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N <br /> I .11(I. f i'eannnfrl ..w(., �'1 Mt111/t <br /> An16un,fla V.n Spron4on 1b01't-{S1 H-11Crlon Avon Oa, f,. O 110. %U(19 �..+ min Cllr nl t u01 <br /> (.II PImanNl - Joapuln County <br /> Slocklon. California 95?01 City of Eacaton <br /> F un f L. Flou0bgo - Clly of Manlaca <br /> John L. Flora _ 209/�6fi-6791 City of noon <br /> John O. Ma.1, M.O. - - Clly of SlocMlon - <br /> William J. Wada Jool Khanna, M,D,• M,P.H. Ctl <br /> Mary Ann. Lor. DIa IrICi IgNlh 011lur y or Tracy <br /> San Joaquin County <br /> San JoaQuln County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1. the undersigned owner and/or operator of the property and/or facility <br /> located at ' <br /> hereby authorize EPE e p n to release any and all analytical results. geotechnical data 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. Title:` <br /> Address <br /> Phone: ff5I- 7-:x/7 <br /> S a-fio <br /> Date: //9/p 7 <br /> 1 f <br /> EH 08 05 UGT 13 , <br />