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.oaAo of IAUSeEES SAN OAOUIN LOCAL HEALTH DISTRICT st Av INO . <br /> Jemae .ulp•n eon, Pr•e. _ City of Lodi <br /> rWKb E. V•nnuptl. $•Cy San Jo. <br /> An lisle ..va So cl- Sen. 1601 East Hazelton Avenue;P.-0. Bo. 2009 qufncouniy.. <br /> City of E acaton. <br /> f.n rimeniai Stockton. Calllofnia 95201 City of Manteca <br /> Fam 9uoo.a 209/466-6781 City of Ripon <br /> Daniel L. Flotu City of Stockton <br /> John D. Mut, M.O. City of Ttacy <br /> William J. Wade Jopt Khanna, M.D.,M.P.H.. Dlatnd Health Officer San Joaquin County <br /> Man w Anna lo <br /> 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 i L� (lyl��.1� JT fpsy Z <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 /> Owner/Operator: Title: WK) EAR, <br /> Address ��� 1 JS�I MY�� aJ5 � Phone: <br /> �77 V 9.Lo *CRU E � 5MC) <br /> Date : <br /> It 08 OS tlGl 1 <br />