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. C" �•^>�n. ir-1.1 OUIN LOCAL HEALTH DIS - <br /> . V.nnwcc, Swc'y % <br /> _ <br /> on,ll, V,n Snron..n <br /> -I pl.n.nl.r �1 East Huelion Av • Slave.,° <br /> enue, P. C D0, 201a,3,rn Bopp„ SIOC1C10n Cllr o(lo6t <br /> Oanbloa r <br /> L. Flo(*, <br /> Stockton. Californiaallfornia 95?01 u°'^Court <br /> John °. m"t. M.O. /4GG.b�D 1 Gly or l.c,ron <br /> Vlllll,m <br /> J. Nod• City <br /> city or n1pon <br /> Miry Ann. tor, Joplh,nn,, M.O.. M.P.M. city o(Stoc\ron <br /> . nl,Irlcl ft„Rn orn,, <br /> Gtr of T r,cr <br /> S,n Jo.Quln Co�nrr <br /> "n Jo,pul^� my <br /> AUittOR1ZAT10rr i0 RELEASE Ar;nlYT1('jtiL RESULTSRD9919M00 <br /> , <br /> SITE FSSESSNEnT INFORru,Tlon GEO7ECH!r1CAl DATA ntrD MAY 31 1988 <br /> [ENVIROMENTAL HEALTH <br /> 'N.PERMIT/SERVICES <br /> I , the undersigned owner and/Or <br /> located at operator of the <br /> Property and/or facility <br /> � f,ti <br /> hereby <br /> authorize <br /> to release any and all analytical results <br /> assessment inforuation to the San Joaquin geotechnical data and <br /> site <br /> q <br /> as it is available and L°cal Health District as Soon <br /> at the sar>e tip it is Provided to me or my <br /> representative. <br /> Owner/Operator: <br /> Address -j-L �IF\rlt. ( 14r Title: <br /> T � c�V i , u <br /> Phone: <br /> Date: MJ(k\/ <br /> r <br />