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- r <br /> �xos 1 r •s c t 1 °�— �`i l2 <br /> SAN j . ,kOUIN LOCAL 14CALTH U1SI Ili <br /> lames CwGen2on. roe,. <br /> Pair la S(,RVINQ <br /> lC �. V�nnuccl, Sec'y- <br /> A.rihonette Vaa SWor►senCITY a(Lodl <br /> 1601 fast HazCttan Avenue P. O. Box 2009 z} Son 1oaQuin coUntr <br /> , l Slacktc)n.California 95201 Ctty of Eacaton <br /> ]anW t.. Ffwes 209/458-6781 cltyof man,0-" <br /> Iohn 0. Mast. M.D. City of Ripon � <br /> Yfplam J.Wade Clty of Stockton <br /> Anne Lore Jopt Khlinna, M.p.. M.p.H.. District Health Offlcer C1U Of Tracy <br /> W San JoaQuln County <br /> San JoaQuln County <br /> AUTHORIZATION TO RELEASE ANALYTICAL. RESULTS. GEOTECHNICAL DATA <br /> SITE ASSESSMENT INFORMATION <br /> I. the undersigned owner and/or operator of the property and/or 'facility <br /> located at <br /> - <br /> hereby authorize EA Engineering, -Science, and Technology,' Inc. <br /> to.release any and all analytical results, geotechnical data and site <br /> assessment W0179tlation to the San Joaquin Local Health Oistrict as soon- <br /> as it is available and at the saltie time it is provided to me or my <br /> representative. - <br /> Owned/OPerator: <br /> Address G� p f bks Phone: <br /> Date: goer q� <br />