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�. . ti rel III 1 1I.J i 1 tii . I 1� �.L,VL-,) iUI! <br /> Anlhunalle V.$.Klnlon►en }{►U aSI 11 <br /> Cllr nl l odt <br /> , 1cllon AvLnlio, f . U loci► ?(Kl`3 <br /> San JoaqulnGb <br /> ..r unly <br /> Er�Iman`.►1 Stockton, Calll cit o1 ,colon <br /> F am Owoeee ornia 95201 r E <br /> Daniel L. Flores 2011/466-6781City of Menlace7H1 City of nlpon <br /> John D, Malt. M.D. Clly of Slocklon <br /> W111tam J. Wada Jopl Khanna, M.D., M.P.H., Dlatrltl I-feailh Officer City of Tracy <br /> Mary Anna Lova San Joaquin County <br /> San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. _GEOTECHNICAL DATA AND <br /> S3TE-ASSESSF1EFff INFORMATION <br /> I . the undersigned owner and/or operator of the property and/or facility' <br /> located at ,� <br /> hereby authorize' Ld <br /> to release any and all analytical results. geotechnical data and site <br /> assessment inforniation .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 /> Owne�/0 erator: � '( i Title: <br /> Address ��� ( ' <br /> Phone: 5so <br /> Date: <br /> MAY 2 71968 <br /> ENVIROMENTAL HEALTH <br /> PERMIT/SERVICES <br /> } <br /> EH 08 OS UGT 13 <br /> ti <br />