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,STEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> Pres. City at Lodi <br /> /ice Pre. 1601 East Hazedon Avenue, P.O. Box 2009 San Joaquin County <br /> m'S` 'Y. San Joaquin County <br /> Stockton, Cardomia 95201 Cty of Escawn <br /> city of Manteca <br /> s (209) 466-6781 City d Ripon <br /> City of Slockton <br /> M.O. Jogi Khanna,M.D-M.Pm,District 1l"m officer City of Tracy <br /> im San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the unders : a owner and/or operator the property and/or facility <br /> located a -� L, <br /> hereby authoriz <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment -information to the San Joaquin Local Heath District as soon <br /> as it is available and at the same time it is •provided' to me or my <br /> representative. - <br /> Owner/Operator �� C t�C �v <br /> // Title: Q <br /> Address 3 , 7 €. _ Phone: — �7 <br /> Date: �- 3L, <br /> ��I, ,�► uvtl <br /> J U L 71989 <br /> ENVRRONVLNTAL f-!EALTH <br /> PERMI T/SERVICES <br /> EH 08 OS UGT 13 <br />