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.,i, • tJlJli. 1 tl ., l 111 rel I I1 I11; I I I <br /> 14 v t P4 <br /> r►rr c i. ( b.,,r.,rcU ....0 y Clty nl t odl <br /> An•I�,)netie Van Slrron,an 1601 C Ast Halellon Avent10, {'. O. H()z l()()<) .an Joaquin CUunly <br /> E ail Plmenlel Stockton, Callfornia 95201 <br /> Clly of E3calon <br /> F a:n Bupbee Clly of ManleCe <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Malt, M.D. City ofSlocklon <br /> William J. Wade Jopl Khanna, M.D., M.P.H., Dlelrlct Health 011lcer City of Trecy <br /> Mary Anna Love San Joaquin County <br /> Sen JoaQuln County <br /> SEP 2 1987 <br /> ENVIROMENTAL HEALTH <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND FERMIT/SERVICES <br /> SITE ASSESSMENT INFORMATION <br /> I . the undersigned owner and/or operator of the property and/or facility <br /> located a t (0 l G(D <br /> hereby authorize ( /r �2h0ru�DrlP�L <br /> —�.— � �•d�rzt vyz2Y� <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: o--Ti tl e: �r <br /> Address $ S1,41 <br /> P14 Phone: <br /> Date: f a(r ( 9 8 7 <br /> J <br /> rew ova. r�Oc o- e r�r <br /> w�� � aer�c nom , g <br /> ! 6) 3 '7;? - 2 75-5- <br /> EH 08 05 UG T 13 Vj S C,C p j,_ `i n-Le-,4-14 ZLX ` (p f II kCe4IL/ . <br />