Laserfiche WebLink
� * r.i/. ilJllll. I l /� ./ t 111 /�I Ill 111,/ 11 I <br /> City of ( udl <br /> Anittunetle Ven Spron>,en 1(,Ul (_,Is( 11.11ellon Averlllo, F.P. 0. f1Ox )(xSen Joaquin <br /> Cuunly <br /> (erl f Imenlet Slocklon. California 95201 City of c3calon <br /> Fern ©uooee City of Manteca <br /> Oanlel L. Flores 209/466-6781 City of Ripon <br /> John D. Ma71, M.D. City of Stocklon <br /> William J. Wade Jool Khanna. M.D.. M.p,H.. Olelflcl lieal(h Offlcef City of Tracy <br /> Mary Anne Love San Joaquin Cuunly <br /> Sen Joaquin Counly <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> Ie the undersigned owner and/or operator of the property and/or facility <br /> located at jl1 1 �� �t ��t� 7 <br /> hereby authorize ,t <br /> to release any and all analytical results. geotechnical data and site <br /> 4ssessment 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: <br /> Title: <br /> Address Phone: 797— `/ZZ <br /> � s 33 <br /> Date: s-'—� 7 <br /> EH 08 05 UGT 13 <br />