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' = Nil <br /> WNr <br /> e ING <br /> BOARD OF TRUMEES SAN JOAQUIN LOCAL HEALTH DISTRICT cof f.aduyofLoo <br /> I <br /> Jamaa CunmrlaOn, Pras, Sart Joaquin County <br /> Putrlela E. vannuccl, Sody. 1601 East Hazolton Avenue, P.0.BOX 2009 City of Eaaclun <br /> Anthonatts Van SPronsrd City of Manicn.e <br /> Earl Pimentel Stockton,California S5201 City of Ripon I <br /> Fern Bugbea 209/466-6781 City o1 Stockton <br /> Daniel L.Floras City of Tracy <br /> John D. Mast,M.R. San Joaquin County <br /> wlillam J. Wada Jogk Khanna, M.0•, M.P.N., pkslrlct Health Otticer San Joaquin County <br /> Mary Anna Love <br /> r-� <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1, the undersigned owner and/or operator of the property and/or facility <br /> r;=t located at 17000 E. Highway 120 Ripon, CA <br /> hereby authorize California Water Labs <br /> to release any and all analytical results, 9eote^ cht»cal data and site <br /> assessment ilkfaru�ation to the San Joaquin Local Health District as soon <br /> as it is available arld at tile,Sallie time it is provided to ale or any <br /> • representative. <br /> �./ Title <br /> r <br /> OWI IQ -/0perat.ur: c_i ~,._ <br /> Phone: <br /> ski Address <br /> i <br /> Date: <br /> x <br /> u <br /> EH 08 05 <br />