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JAMOS cult)0(1:10n, P(03. <br />("al(Icla E. Vannuccl, Secy. <br />Anihonollo Van SpIon3en <br />Earl Pirnonfol <br />Fern'Sugbee <br />Danlif L. Flores <br />John 0, Mast, M.D. <br />William J. Wads <br />Mary Anna Love <br />0 0 <br />SAN JOAQUIN LOCAL I­1EALT11 DISI HICT <br />1601 East Hazellon Avenue, P. 0. Box 2009 <br />Stockton. California 95201 <br />209/46"781 <br />J091 Khanna, M.D., M.p.".. District Health Officer <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS. GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFORMATION <br />0 <br />SC14VINO <br />qll y of L odl <br />San JoAquln County <br />City of E2calon <br />CllY Of PA'Anto'ca <br />City of 141pon <br />City of Stockton <br />City of Tracy <br />San Joaquin County <br />San Joaquin County <br />1, the undersigned owner and/or operator of he property and/or -facility <br />located at <br />hereby authorizeLMAA C�s�=.IcL s <br />to release any and all analytical results, geotechnical data and'site <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 />OwnA;Operator: .6_Title: vte <br />Address 'z Phone: <br />......... <br />Date® C" <br />