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aO.Aoor IAIS t((s SANJOAOUINLOCA <br /> J-n`.I Culu.0.on. P,., L HEALTH DISTRICT <br /> P.I,ICI• E. v.nnuccl. S."r SERVING <br /> nnlhonatle van SWOn,en 1601 East Hatelton Avenue, P. O. Box 7009 San Joa Clly Of Lodi <br /> (.,I Plm.nlal Ruin County <br /> F.,n oupo.. Stockton. California 95701 City of Eac.lon <br /> Oanlef L. Flofaa 209146"781 Clly of Manteca <br /> John 0. Maal, M.O. City of Ripon <br /> William J. Wade Jopl Khanna, M.o., M.P.H., Clly of Slockton <br /> Mary Anna toolalrcy Healfh o(IlcaCity of Tracy <br /> San Joaquin <br /> County <br /> San Joaquin 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 ��f' y /_ f �� <br /> hereby authorize �� 4 y� 1 ' <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment information to the San Joaquin Local Health District as soon <br /> as it is available and at the same time it is provided to file or my <br /> representative_ <br /> Owner/Operator: Q` Title: p_p� <br /> Address ��Cc' Z5.7 �e Phone: <br /> 9yl-512—,3-A <br /> Oatc: <br /> CH OR ns Uf,i 11 _ <br />