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bURHL' UI tRustus SAt*AQUIN LOCAL 11[AL1 ti UISlWT <br /> SLR VINO <br /> Jame, Cuit onson. Pres. City of Lodl <br /> Palricla E. Vannuccl, Secy. San Joa uln Count <br /> Anthonette van Spronaen 1601 East Hazellon Avenue, P. O. Box 2D09 c <br /> City of Eacelon <br /> Earl Plmentel Stockton, Callfornia 95201 City of Manteca <br /> Fern Bupbee 209/466 6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jog[ Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love 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 anlId/or)) facility <br /> located at (o2trj --y". l /'�.L�CVI�J/A�f�( �), �TOGLloYI <br /> hereby authorize Jw, 11�orp� 61 1 JA C' ' <br /> to release any and all analytical results, geotechnical data and site <br /> dssessment information to the San Joaquin Local Health District as soon <br /> as it is available and at the same time it is provided to r my <br /> representative. <br /> Owned/Operator: <br /> Address 6ZLS r Phone: S — -71) <br /> S' 10 CA <br /> Date: V7 <br /> e <br /> EH 08.05 UGT 13 <br />