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■0-1100! IRui.EES <br /> J.m•. Culbertson. P'.•&, SAAAOUIN LOCAL HEALTH DISTRf T - <br /> Panicle E. vannupct,-S•c'y, - SER VINO <br /> Anlhon•Il,,-van Sp,"-,.n. 1601 Easl Haretto_n Avenue;.P. 0. Boa 21x19 San Clty of goal <br /> Ea.f flm.nt.l - Jo�puln Counly. <br /> F•fn auoo.. - Slocklon, Callforn.ia 95201 - - City of Eacaton <br /> Daniel L. Flow - 209/466-6781 - city of Manteca <br /> John D. Masi, M.D. _ - City of Ripon <br /> William J. Wad. J091 Khanna. City Of Stockton <br /> Mary Anna Loy. M.O., M.P.H., Oblflct Health 01fk.w City o1 Tracy <br /> San Joaquin County <br /> San Joapuln County <br /> AUTHORIZATION'' LO 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 191.,5 East Lathrop Road, Manteca, .CA 95335 <br /> hereby authorize <br /> to releas$ any and all analytical results, geotechnical data and site <br /> .ssessmenpffntoyinat'ion to .the San Joaquin Local Health District as soon <br /> as it is 41aiilAlbfe' and at the same time it is provided to flee or my <br /> representative. N, <br /> k1e5t, n S4 . pr . <br /> Owner/Operator , -b ,.� �sJ Inc <br /> Title: Equipment quipment Manager <br /> P - .Box 71 Phone: 209-523-5615 <br /> — ©des 25 Ck 95353 <br /> qr <br /> SII <br /> 08 05 UGI 13 ' <br />