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1■mio Gulbenson. Pres. aLriVsmu <br /> PatriCl■ E. V■nriuccl,.SeeCity of Lodir. San Joa vin <br /> Artllpnefte Van Spron,3en 1601 East Haze11on Avenue. P. O. 80x 2U09 4 County <br /> Earl Pimenlel <br /> Stockton. Gallforma 95201 Ctty or E�c.lan <br /> Fern Bupbee Cityof Manteca <br /> Oaniet L. F+ores 209/466-6781 City of Ripon <br /> John 0. Mast. M.0• city of Stockton <br /> SanCity William J. Wade Jooi Khanna.. M.0.. M.P.H_; i?fatricl Ffesfth Officer.. Joaquin of runty County <br /> k Mary Anne Lore <br /> San JoaQufn County <br /> AUTHORIZATION , <br /> TO RELEASE ANALYTICAL RESULTS, GEOTECIlNICAL DATA -AND <br /> { SITE ASSESSMENT INFORMATION <br /> �I I , the undersigned owner and/or operator, the _ <br /> 4 P property and/or facility <br /> located at X825 E., MTIIER ST,SM=_CA' <br /> - - <br /> hereby authorize �F.F.G.L. NELSEN_LABOgATpRY of SIOC KION _ <br /> { to release any and all 'analytical ' results, geotechnical data and site <br /> - <br /> { dssessment information to the San Joaquin Local Health District as soon-, <br /> i <br /> as it is available and at the saute time it is provid.ed.. to me or my <br /> representative. <br /> } Owne /0 erator• <br /> �' P �n� �� - Title_ ' ����y�_ o���.� zo��C <br /> Address 0 -BOX 1 Phone_ <br /> s 931-616.I <br /> r <br /> Date. I3' SEPT 1.988 <br /> . 5 f <br /> k <br /> l <br /> 1.11 08 05 UGT 13 <br />