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•0APD.9f IFIVSIEES SAN , AQUIN LOCAL HEALTH DISTRi, SEBVINO <br /> isms* Culeerlson. Pref. City of Lodi <br /> Paiilchi E; Vannucci. Secy. Sen Joaqulo G'unty <br /> Anihoneile Ven Spionsan 1601 East Hazelton Avenue, P. O. ©ox 2009 <br /> City of Esc elon <br /> Earl Pimenfat Stockton, California 95201 City of Manteca <br /> Fein eupoes 209/466-6781 City of Ripon <br /> Danlol L. Flores City of Stockton <br /> John D. Mast. M.D. City of Tracy <br /> William J. Weds Jopl Khanna, M.D., M.P.N., District Health Officer San Joaquin County <br /> '.tary Anna Love 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 3 7S� L..) 7— <br /> hereby <br /> hereby authorize STacV-t-0r?._�,c1a�r <br /> Lo 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 /> 2 02 <br /> Ownef/Operator: Title:—L)14tzw�' ` <br /> Address Phone: <br /> Date: pZ�� <br /> LH 08 05 UGT 13 r <br />