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- <br /> 80AHC OF TRUSTEES <br /> SAN JORQUIN LOCAL HEAL i HpISTRiCT SERVING <br /> yot Lodi <br /> County <br /> James Cu"rtaon, Was. San•lofty of scalon <br /> Patriclr E. Vannucct, Sac�y- 1601 East Hazelton Avanue,P.O. Box 2x09 city of Eantbcs <br /> Anthonetle van Spronsa¢ City 01 of Alpon <br /> ' Ep+rl Plmontel Stockton,Californial95201 city of Ripon <br /> tockton <br /> Fern Dogbee 209/466-6781 City it of Tracy <br /> Daniel L.Flores city of Tracy <br /> San Joaquin County <br /> ? John D. Masi. M.D. Jopi Khanna, M.D., M.P.H., District HeallhoinCer San Joaquin County <br /> William J.blade <br /> Mary Anne Love <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 at 170 00 E• Highway 120, Ripon CA <br /> hereby authorize California Water Labs eo—�h •cal— data and site <br /> to release any and all analytical resg'Its, g <br /> assessment information to the San Joaquin Local Health District as soon <br /> k as it is available and at the same time it is provided to me or lay <br /> representative. 1 <br /> +� Title: /Z/1' ` <br /> erator' <br />` owner/0 p bane: <br /> Address _ .e. <br /> ._.^ <br /> Date: <br /> i <br /> q <br /> a <br /> F, <br /> } <br /> EH 08 05 <br /> , 1 <br /> . I <br /> " 1 <br /> j <br /> 1 <br />