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e�a'Ro of TRUSTEES SAN JOAOUIN LOCAL HEALTH OCT <br /> J.m•.culb«l. .►,«. IZiF( SERVING <br /> ►-.ry Anna do �•►'. <br /> I.u1c4 E.Vannucd1601 East Hacetlon Ayenuo. P.O. Box 2009 Cny d Lodi <br /> , n«'y. 260 Joaquin Counly <br /> E.A/Im"W Stockton, California VS201 San Joagw,C°,jy <br /> City of E.calon <br /> Ori Maw"• (209) 466-01Y81 City of Manlaca <br /> O.nlal L Fbr•. Clly N Rlpon <br /> Join 0.Mad$,M.O. Joel ah.ana.MAS M.►.N�OMk{d Nsakh oocw Gly of Slocklon <br /> o.na t.Kreham Clly of Tracy <br /> S"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 anal tical 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 /> .T�r�s Gv�//r.•-�Ls <br /> Owner/Operator : <br /> Title:./ <br /> ndUre:;S Thune: �2/3 <br /> /'a' /YW u 2 a 7 Ll.w?C- <br /> Date : <br /> GDate : <br /> EH 08 05 UGT 13 <br />