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SAI` OAQUtN LOCAL HEALTH DlS j CT SERVING <br /> naon. Prea. <br /> . E. VannUOCt. Se1601 East Hazelton Avenue P. O. Box 2DO9 - Sen Joaq City <br /> of Lodl <br /> Anthonetle Van 5pronsen , <br /> County <br /> ontl <br /> Earl Plmentel Stockton. California 95201 City of Escalon <br /> Fern Bugbee City Of Manteca <br /> Danlel.L. Flores 2D9/466-6781 City of Ripon <br /> John D. Mast, M.Q. <br /> Clly of Stockton <br /> City of Tracy <br /> William J. Wade Jogl Khanna, M.D.s M.P.H., Distr ct Health Officer San Joaquin County <br /> Mary Anne Love San Joaquin county <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEO ECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1, the undersigned owner and/or operator of the property and/or facility <br /> located at Q <br /> hereby authorize <br /> to release any and all analytical results, geotechnical data and site <br /> dsscssment 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: �� O Lc . C S Title: d tom)yti4 <br /> Address 6la Phone: f' <br /> Date: <br /> EH' 08 05 UGT 13 <br />