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a+�tioGr IfwSAN..,,OAOUIN LOCAL lit ALIli UISn.ACT <br /> 7�rt�ea CuILerlaon. Pros St.HVINn <br /> Patfl:la E VannuCCI. SnC'y Clly of tOdt <br /> Anthonetle Van Spfonsen 1601 Cast Hazelton Avenuo, P. Q. Box 2019 San Joaquin County <br /> Earl Plmenlel Stockton, Callfornia 95201 City of Escalon <br /> Fare Bupoee City of Manteca <br /> Daniel t. Flores 209/466-6781 City of Ripon <br /> John D. Mast, M.D. City of Stockton <br /> William J. Wade Jopl Khanna, M.D., M.P.N., Dlatrlct Health Officer City of Tracy <br /> Mary Anna Love San Joaquin County <br /> San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I, the undersigned owner and/or operator of the property and/or facility <br /> located at <br /> hereby authorize <br /> 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 /> r I/ <br /> Owned/Operator: 1Q��� Title: O i -&Cif /�,k- <br /> Address qsy S S• b1r4r21 a I Phone: C/Bz-1q73 <br /> FPP-AlcG Clc�n� 95 3j <br /> Date: 4-3-87 <br /> oo � bt <br /> c 987 <br /> ENVti, ` E(,4TAL HEALTH <br /> PERMIT/SERVICES, <br /> EH 08 05 UGT 13 a <br />