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NlyJ-07-1994 15.15 FROM GEOLOGICAL TECHNICS TO 4640138 P.06 <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> EWIRONMENTAL HEALTH DIVISION <br /> (299) 46&3420 <br /> AUTHORIZATION TO REL FACE <br /> ANALYTICAL RESULTS <br /> 4 GEOTECHNICAL DATA <br /> ' <br /> ENVIRONMENTAL/STM ASSESSMENT INFORMATION <br /> 1.THE UNDERSIGNED OWNER AMI OR OPERAT,OR OF THE PROPERTY AND/OR FACR= <br /> LOCATED AT I b ?45 47Aw,,Jre RD, shXI-6f.! <br /> HEREBY AUTHORIZE (SUM`C=)I.D(r;GO�L. <br /> INC.- (�rgzk zp , <br /> (dabwatary or Caaanp aw) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> HEALTH SERVICES AS SOON AS IT IS AVAILABLE AND AT THE SAME TINM IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME <br /> (jIAPP ) <br /> OWNEIVOPERATOR. mtkz Mdvy o lkrJ T Lcsv4-v- <br /> (Pfetgc F4bu) <br /> (owpWopermw sipaum .) —t--- •-- <br /> ADDRESS Imo" O la Im 5018 <br /> Mo-ossTo GA 9535 Tom. <br /> fciw (State) (lip Cade) <br /> PHONE: ( zzl j 1_. zq —I-OX <br /> DATE <br /> /! L <br /> EH 23 041 (Revised 7-10-92) Pap 9 <br />