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TEL No . ' Mar 8 . 88 11 :_54 P . 03 <br />/.80ARD 6F TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br />-f .James Cuibertaon, Pies_ City ofLodl <br /> p,t,tcta E: Vannuccl, Secy. 1601 East Hazelton Avenue P. Q. Box 2009 San Joaquin County <br /> Anihonatte Van Spronaen City of ESCatctn <br /> Earl Pimento, Stockton, California 95201 City of Manteca <br /> F•rn supbes 209/466-67$1 city of Ripon <br /> Daniel L. Floras City of Stockton <br /> +. John 0. Mast, M.D. City of Tracy <br /> Wililam J. wade Jopi Khanna, M.D., M.P.M., Dlatrict 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 /> 1, the undersigned owner and/or operator of the property and/or facility <br /> ir_# L* . /5- !�,located at K <br /> 9 r <br /> hereby authorize 6 1001 4-1-ad 2L <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 the or my <br /> representative. <br /> • owrtJ/Operatar: <br /> Title: �re*x� <br /> Address - <br /> , Phone: 7o7-�7`f�-� <br /> Date: <br /> EH 08 05 17GT 13 - <br /> -+r <br /> _ <br />