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W/ 0/20135 09;01 251.433 EHD PAGE B7 <br /> SAN JOA.QUIN COUNT' <br /> ENVIRONAIENTA[,HEALTH I?EPA.It,TNTENT <br /> (409)469.3430 <br /> AUTHORIZATION TO RELEASE <br /> `ANALYTICAL RESULTS <br /> ' GEOTECHNICAL DATA <br /> t,` ' ENVIRONMENTAL/SI'YEASSESSMENTfNFORMATION <br /> - <br /> 1, 1 t 1 UNDMWNED OWNER AND/OR OPERATOR Or TNL•pROpER7y A,Moa FACILITY <br /> LOCATED AT?cO )9 <br /> ($flet(AddrrltJ (Cry) ^` <br /> [IMPYAUPHORIZE M <br /> (LudaIeM19J '— �—` <br /> TO PtLEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONM&NTAL H.6ALTP <br /> Dc PA RTMENT AS SOON AS IT 15 AVAILABLE AND AT TRE SAME <br /> TIME IT IS pRO V1ryED TD ME OR MY REP1tESE)gTATIVF- <br /> HUSINESSNAM[: <br /> 0WNMUoFERATOR: A ' <br /> lv <br /> (Pie e P lnQ lid! <br /> (O erhlot 'm\\arc (bale) <br /> ADD 5: O 7 C. aTH /~ <br /> {MaUlag,(ddrrttJ <br /> A, ` 52.3 <br /> .7 �y (C7tyJ (,Rare) (F40 Code} l <br /> PHONE:k GC) -( 1 <br /> F.hl Z3 Oab (RtViscd 1/24102) <br /> 6 <br /> CUO(�] YFd WCO OTOZ%!Z;OT <br />