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MR <br /> 1.^ r1.(.^71.w,1.nn_ ` 5a I�,,.�E �,....11.,f Jtf� ! 1 <br /> t:1 <br /> P.it it 1, f. 1'eni..rfCl '.nC'1 ��'" Clly M 1 Udl <br /> AnLhunelle Yon Sl7innsen 1601 1-AS1 H-Alel1Un Avenuo. N. l!Ox 7(IU9 Sart JoaQulnCuunlr - <br /> L off rlm:nfel Slocklon, Callfofnia 95201 <br /> Clfy o1 I:scelon � <br /> Fein Bupt)ea City of Menlece <br /> 0anief L. Flores 209/466-6181 City of Ripon <br /> John O" Mail. M.O. City of Slocklon <br /> Wlfllom J. Wade Jog[ Khanna. M,0„ Myjj_, Oletrlel {eellh Offleel City of Teecr <br /> Mary Anna Love San Josquln County <br /> San Joaquin County <br /> I <br /> i <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 /> located at �az <br /> hereby authorize ,,,d/�„y <br /> to release any and all analytical results. geotechn cal data and site <br /> assessment information to the San Joaquin Local Bea th District" as soon" <br /> as it is available and at the same time it is provi ed to me or my <br /> representative. <br /> Owner/Operator: Title: <br /> Address p Mone: _ g <br /> Date: <br /> JUN 23 9987 <br /> ENVLROMENTAL. HEALTH <br /> PERMIT/SERVICES <br /> EH 08 OS UGT 13 <br />