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x <br /> SA IOAOUIN LOCAL [HEALTH DIS ICT S(RVING <br /> s /Jarnes Cultior,son. N. _ <br /> PaftlCla E. VannuCC1. SaC'y. Ctlyof f.odl <br /> Anlhonalle Van Spronson <br /> 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquln County <br /> Earl Plmenle! Stockton. California 95201 City of Esca,on <br /> Fern Bugoae City of Maniac& <br /> Daniel L. Flores 209/4616-6781 City of Ripon <br /> John 0. Mast. M.D- City of Stockton <br /> William J. Wade Jogi Khanna, M-o.. M.P.H., DlaCity of Tracy <br /> lricl Health Officer San Joaquin County <br /> Mary Anna love San Joaquin County <br /> 1 <br /> AUTHORIZATION TO RELEASE ANALYTICAL, RESULTS, GEOTECHNICAL DATA AND <br /> 1 <br /> SITE ASSESSMENT INFORMATION <br /> I, the undersigned owner and/or operator of the property and/or facility <br /> located at 2500 WEST LODI., LODI , CALIFORNIA 9524a <br /> hereby authorize GETTLER-RYAN INC. ' <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 /> e-aKs/ <br /> Owne�JQperator: e" Title: <br /> Address / 3 GJ. �i�r�c Phone: (Zr3) <br /> Date: <br /> f ' <br /> EH 08 05 UGT 13 <br />