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.aC-r ►u.,. <br /> LM`�`• <br /> ► �'« 1601 E..t H�c�Kon 2009 —�-o.. cair:(�.a• <br /> '"LV <br /> E.A►Mw«�f.l u�O+.caIHorwe IS201 t'•�J••Qul�C«.M► <br /> Clay 0(6C 040., <br /> Ov"L Floe" MMNM.� (209) 466-4161 'Cky of Mt.c. <br /> �.�1.f <br /> J.1w10.mao,MA. rAy-ai RP°" <br /> O«N IL Kt*h&#" ��•^�MAS 04-PAIL.04%40 H*"Vt Oac.f phh a Flo" <br /> -- _ 9"Jw I✓�^b <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS GEOTECi{LAICAL DATA AND <br /> SITE ASSESSMENT INFORKATION <br /> M I <br /> I • the uwdersigned owner and/or operator of the <br /> property artd/or facility <br /> located at � �^e <br /> hereby authrorizeto release any and all analytical results. <br /> K chni <br /> assessment information to the San Joaquin Local el(ealthlisDtr and sft� <br /> � ° s available`s it ia trict as soon <br /> and at the same time it is provided to me or my <br /> representative. <br /> c� <br /> Owner/operator - <br /> Add <br /> wner/Operator <br /> Title: ti < /� <br /> /1 V cl r es,,; <br /> , <br /> 17) ,-, CI'L� ' L'hunt.. ' c• / <br /> Date . <br /> i - <br /> r <br /> f <br /> �vI 1n j . <br /> EH 08 05 UGT 13 <br />�lfC. ,, ...'hl' •i"t '�'%t�L .'r� Y1.-.y •-.''•t< !�"+�Xi/r �' •ni';• �.t:•P i :.ti. ���•-7.r 3 r....r... <br /> �N�♦'ti11�Vi•�•i N • .. . ... . . 1.-. 1•. "y— •.rtJ�.L•n'•'�•�.)f..,. <br />