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l.n C.vel.".t.tui 1'. .. .,i . i . i •. 111 il i I 1 I i ,) <br /> .. uclt4O <br /> /`.ISI/ i. i \•.•",..ccl .... . <br /> Cltr of 1 odl <br /> Anlhunslts Van Stllonlen 1(,UI (_.151 11.1JC11Ut1 Av(;tmo. (j. O ((Ut JOAQuin County <br /> Q <br /> E•II f'Imsnlel Stockton. Callfornia 95201 City of EsCaton <br /> F•in OuQDea City of Ma <br /> nteCa <br /> Oanlel L_ Flores 209/466-£>781 City or FnfeCa <br /> John D. Malt. M O. 1pon <br /> City of Slocklon <br /> W1111am J. Wads Jopl Khanna, M.p.. M.P.H.. District Health Officer Cltyof TIeCy <br /> Mary Anne Love Sen Joaquin County <br /> San Joaduln County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> I , the undersigned owner and/or operator of the property and/or facility <br /> located atI <br /> hereby authorize <br /> to release any and all analytical results. geotechnical data and site <br /> ,issessment 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/Opera <br /> tor: <br /> Address Title: C/!�LAWAA <br /> , , <br /> s Cf �g�, Phone: Z0Z- `/22 -/Z-9 <br /> Date: _ s-,—� 7 <br /> EH 08 05 UGT 13 <br />