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d-06-1998 8:58AM FRtAIT SACRAMENTO 916 635 2606 P. 11 <br /> • <br /> SAN JOAQUIN COUNTY PUBLIC HEALTHSERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209)468-3420 <br /> AUTHORIZATION TO RELEASE <br /> " ANALYTICAL RESULTS <br /> "GEOTECHNICAL DATA <br /> " ENVIRONMENTAIJSITE ASSESSMENT INFORMATION <br /> 1, THE UNDERSIGNED OWNER ANDIOR OPERATOR OF THE PROPERTY ANDIOR FACILITY <br /> LOCATED AT -73c;,'3 PAcrrlc AUe' 44oe f �u> . C A ` �a7 <br /> (Street Address) <br /> HEREBY AUTHORIZE - rh ramy) IC � <br /> (l abOrffipry) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> HEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME <br /> TIME IT IS PROVII)ED TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: '-rCS 5 CCo Fc4G1 — Ty !S-4z ( <br /> (#Applicable) ! <br /> O'WNER!OPERATOR: �e�N �3AR(QQ7 Seek <br /> (Pl®ose Print) Mlle) <br /> 00,wnerf0petator stgmwre) (Date) <br /> ADDRESS: 2 8E�,-j s.,h7 R l5 i <br /> (Mailing Address) <br /> t�nti cl�a rr�r �1 t^A c5is 7q2 <br /> (City,) (Slate) (&'P Cd&) <br /> PHONE: ( <br /> EH 23 046 (Revised 911I/96) Page 9 <br />