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r rrER TEL hln: 1 �9 942-4=13 #?�6 P�2TAd 4— k :JEL 14:16 I D:Srl: a. �CA;Ea -- <br /> 7�!' FR�oMiNQRCAtt EXECUTIVE OFFF'5. T0;570CKTGN SCAVENOF-R JAAJ 24, 1990 8:35AM F.02 <br /> '"`""'►" `°�' "� 1�k� !AN JOAQUIN LOCAL HEALTH l3i``"OMRICY SERVIN <br /> Mary 4ko L1ra,Viae,Pr41, 1BOt E�ts;S Hibitslic�r�ANbtlut5, P.O. fox 2Ot)!8 City of 0.0 <br /> Pairicia 9,Wannuccl,saq'y, ban.19AgWn Cour' <br /> Tommy JOyC9 Slookton, Calltornio 0201 ffiin Joaquin Coun <br /> fart Plrhmntol City of 13s0N14 <br /> Viryinlr'Malhow/ Clly of Mantel <br /> Denial L.FI0111 (200) 408.0181 City 01 Alpe <br /> Jahn D.Mart,M.D. Ja01 Khsemas.MA,MAH,,District Haolth GM4�r r. City of Slocku <br /> Gent B.Krlham r' City of Teal <br /> San Joaquin Coun <br /> r <br /> AU1110RIZATION TO RELEASE ANALYTICAL RRSULTS, GLOTECHNICAL DATA AND <br /> SITE AS8)?S$f`fBNT I�fk'4•}��h�(i'I`I��`� <br /> I E tho undersigned Owner anti/or operat'oi° of thO Property and/or facility <br /> located at <br /> hereby a.aathorize <br /> to release any and ajll analyticalr ruin t:' �,e.�c�tecf�nac:t��,� � <br /> �la.ta and site <br /> as869kiment information to the San joaquitl Local Health Dii�trict as eoRn <br /> US it f.ty rtiVal.lable a.11d at the .8111710 tinge i9 ILSprpvicied to me or myrepresentative , <br /> Own(31'/Upura.tor : <br /> Address 'rl.tkc . ��. � <br /> �64tCf: <br /> 811 23 04 3/86 <br /> r <br />