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M <br /> will <br /> .•v. v. v. a...va . ova .n..,ti.., na, - <br /> QR� of tALJffiif 90 8AdOAQUIN LOCAL HEALTH OWL' T <br /> tai pm�aen,�IQe. ddf�VlfYO <br /> r Arne t.evS,Mee . 1601 KAstt We:elton Avenue ,o.goy!20@x? N Lao"M 8.61aneE�af,�o-v, +PBan� CnY 0"Ji!County <br /> �1M 6'900 10",COMOMlp 96201 fiats Jaaguie ofti y <br /> 0:.A Mathawe ChY of fai0a;fatl <br /> dao i,rla+aa (209)466.073T CAY at Ift1wel <br /> n a,M411,M.D. City of falp" <br /> tfi B.Klahrm Jag!Khaner,M.D.,U'P.M,,abLiol Maelslt OtRea CRY of Btocklar, <br /> Clic es Tlactyr <br /> fon JQ"U%Ca1My <br /> AUTHIGH2ZAT$UN TO RELEASE ANALYTICAL RESULTS, G CT�Ci3WAL DATA A <br /> SITE ASSESsuzNx $NFC3RDdATisal� AND <br /> z I the undereiSned � <br /> ionated at; the property and/or faoility <br /> hereby authorize 211tat AnOooiated And/ar caii�orats 4Vate� LebB <br /> ,r to relelnaany and all ada.$ytioal re�auitg <br /> geoteahniaa,l data and fait® <br /> x' aeeaeemeec inlgrmation to <br /> the Saa Joaquin Ldod3. Heaat;h District as soon <br /> as it ire available and at the eatr�e tame it <br /> „ 7preeentf3tive, is provided to me or my <br /> y stainer <br /> K Addrun 401 <br /> AK <br /> yt ' Titin: Ey e <br /> k f Date: <br /> N y F'• <br /> 6 <br /> * LH'08 OS UGT 23 <br /> , <br /> _. <br />