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i <br /> eonno tis SAN JOAQUIN LOCAL HEALT14 DISTRICT <br /> i ul <br /> Jame• Gulber.son�on f'rr,� SEpvINo <br /> '"Cls E Vannuc,l ;,r,c y City of Lodi <br /> honetie van Spron5nn 1601 East Hazelton Avenue, P Q ©ox 7oOg San Joaurn <br /> Earl Plmnniel q County <br /> Stockton, California 95701 city of Escaion <br /> OanlFern i3 upVUt, City of Manteca <br /> L 209/466-6781 City of Ripon <br /> WilliJoohnhn D Masi sr 1.,1 p Clly of Stockton <br /> Mary rn J Wade Jopl Khanna, M D M p H District hfealth Officer C11y of Tracy <br /> Mary Anna Love San Joaquin County <br /> San Joaquin County <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS , GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1 , the undersigned owner and/or operator of the <br /> p property and/or facility <br /> located at Y// A lc <br /> hereby authorize <br /> all analytical results , geotechnical data and site <br /> to release any and <br /> assessment information to the San Joaquin Local Health District as soon <br /> as it is available and at the same time it is provided to me or my <br /> representative. <br /> Owner/Operator- PL A) <br /> IJ Tit 1 e: A T ti/9 inyL L,e <br /> Address ,,;-, / } <br /> u /)�'g rsrrls?C Phone: G S � <br /> Date -7 - .-'2 <br /> EH 08 05 <br />