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�• SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 East HaxsHon Avon*, P.O. Box 2009 SERVIA <br />CRYat U <br />San JoaqCoun <br />Stockton, Calitomla 95201 S•n Joagwn coon <br />(209) 466-6761 CM w Esu4 <br />city of M&"( c <br />Joel "Ua MA. ".N. Dk6ld Naaxh ON, ,_n CRY a Rlpu <br />r of stock,, <br />chraTW <br />San Joaquk, count <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />i 1, the undersigned owner <br />and/ot operator of the property and/or ;i located at / facility <br />hereby authorize n <br />to release any and all analytical results <br />assessment information . geotechnical data <br />Co the San Joaquin Local Health Diand site <br />as it is available and at the same tstrior as soon <br />time it is provided to me or my <br />representative. <br />Owner/Operator: <br />�o�K �o /�' <br />Address Title: <br />Phone: <br />Date. <br />EH 08 05 UGT 13 <br />' •'0"0 Of TRUSTEES <br />Janne Wbwwo,, Maa. <br />M" Ann. Lova, Vloo PM <br />, <br />f'. <br />MaNawa <br />0&*0 L Nona <br />ft <br />John 0. Mask M.O. <br />1 <br />Oono & K.M. <br />- <br />�• SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 East HaxsHon Avon*, P.O. Box 2009 SERVIA <br />CRYat U <br />San JoaqCoun <br />Stockton, Calitomla 95201 S•n Joagwn coon <br />(209) 466-6761 CM w Esu4 <br />city of M&"( c <br />Joel "Ua MA. ".N. Dk6ld Naaxh ON, ,_n CRY a Rlpu <br />r of stock,, <br />chraTW <br />San Joaquk, count <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />i 1, the undersigned owner <br />and/ot operator of the property and/or ;i located at / facility <br />hereby authorize n <br />to release any and all analytical results <br />assessment information . geotechnical data <br />Co the San Joaquin Local Health Diand site <br />as it is available and at the same tstrior as soon <br />time it is provided to me or my <br />representative. <br />Owner/Operator: <br />�o�K �o /�' <br />Address Title: <br />Phone: <br />Date. <br />EH 08 05 UGT 13 <br />