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Mar -24-99 01.27P Sanact Inc. <br />117 <br />`/ <br />m <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENV IRS 1NMENTAL HEALTH DIVISION <br />(209) 468-3420 <br />AUTHOf IZATION TO RELEASE <br />ANALYTICAL RESULTS <br />GEOTECHNICAL DATA <br />ENVIRONMEIITAUSITE ASSESSMENT INFORMATION <br />P-02 <br />1. THE UNDERSIGNED OWNER ANDIOR OPI BATOR OF THE PROPERTY ANDIOR FACILITY <br />LOCATED AT J`Y8O0 It'. 6crgC�JTer k k+OnJ -- - <br />(Street Address) r (City) <br />HEREBY AUTHORIZE -A <br />(Laboratory) <br />TO RELEASE ANY AND ALL ANALYTICAL:NFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br />HEALTH SERVICES -ENVIRONMENTAL HEA .TH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME <br />TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br />BUSINESS NAME: J A VJQ C T <br />(If Applicable) <br />OWNER/OPERATOR: Cl1got ek p <br />(Please Print) <br />.or <br />N C . CJS L 0 - <br />R 00Avv- <br />(Date) <br />ADDRESS: �'T �� E. Cay-peNi-Cr good --- ..- <br />(Mailing Addre s) A j` <br />,sg0C- ��oIN (,AIJorW [- 7 g IDC <br />(City) (State) clip Code) <br />PHONE:( a09 )- q& rj — -w 'I*., <br />Eli 23 046 (Revised 9111196) Page rr-(v <br />