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te..r <br />At <br />2795 <br />VSIt <br />Title: <br />Phone: / <br />4ainal Culbailaon, kw. <br />Mail Anna Loot, Vice Pm, <br />Patriots 6. Vonnuoti, Saify, <br />Yonuny <br />CIA Pintaniai <br />Virqinia Maintwo <br />()AWOL. Pkwai <br />John b, Mast. M.D. <br />Cana 8, StOhlint <br />SAN JOAOUTR LOCAL 1-1„.ALTH L1STRic..1 <br />1601 East Natation Avenua, P.O. Box <br />Stockton, California 96201 <br />(209) 466-6781 <br />Jog i Khmw4a, M.D. MAN., Diotrkt It.ltI Otikun <br />grit V i <br />City ol t. <br />San •koaquin co <br />San Joaquin Cm. <br />City 01 6b66 <br />City oi Mani. <br />City ol <br />City col slack <br />Otty of Te. <br />Son Jaagola Caw <br />AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br />SITE ASSESSMENT INFOiMATION <br />I, the undersigned owner .nd/or operator of the property and/or facility <br />located at 4tica <br />hereby authorize /0914 4676,444......-~",,4K <br />to release any and all analytical results, geotechnical data and site <br />assessment information to the $An Joaquin Local Health District as soon <br />as it it available and at. the same time it is provided to ma or my <br />representative. <br />Owner/Operator: <br />Address <br />Do.te: <br />tH 23 041 3/06