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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209) 46&3420 <br /> AUTHORIZATION TO RELEASE <br /> • ANALYTICAL RESULTS <br /> • GEOTECHNICAL DATA <br /> • ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 97 ' East of Mormon Tower / 37 ' North of main track <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE Sparger Technology <br /> (Laboratory or Conrakanl) <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 TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE. <br /> BUSINESSNAME: Atchison, Topeka and Santa Fe Railway Company <br /> (If Applicable) n <br /> OWNER/OPERATOR: Same /'rnC ( Enr ✓Yrnnnan ( IJP <br /> Title) <br /> (�� �1 � <br /> L\ <br /> (Owner/Operator Signat-ure) <br /> ADDRESS: 740 East Carnegie Drive <br /> (Mailing Address) <br /> San Bernadino, CA 92408 <br /> (City) (State) (Zip Code) <br /> PHONE: ( 909 ) 386-4082 <br /> DATE: <br /> EH 23 041 (Revised 7-10-92) Page 9 <br />