Laserfiche WebLink
i <br /> SAN JOAQ UIN COUNTY PUBLIC IIEAIAII SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION ' <br /> (2")4U-3420 <br /> AUTHORIZATION '1'O ItELEASB <br /> I <br /> ----------- <br /> -- <br /> • ANALYTICAL RESULTS i <br /> • GE01'ECIINICAL DATA <br /> • LNVIRONMEN'I'AL/SITE ASSESSMENT INFORMATION <br /> I' 'r1113 UNI)PRSIUNnU OWNLR ANI)/OR OPERAT R OP T1111 PROPERTY AND/OR FACILITY <br /> LOCATED AT ' <br /> trees dd esr) <br /> 11BREDY AU'r11ORIZE <br /> .o ota/ogq or Consa ono <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> IIRAL'r1i SERVICES AS SOON AS IT IS AVAILABLE AND AT T118 SAM13 TIME rr. IS PROVIDED TO i <br /> MC OR MY REPRCSCNTATIV13. <br /> . I <br /> i <br /> BUSINESS NAME : <br /> /garble) i <br /> . I <br /> OWNUR/OPERATOR ; �'A Ras 1/0 9.f. <br /> ADDRESS: ' <br /> (Meiling Addren) <br /> ,tel�D R 'A p•1' <br /> i <br /> (ury) (Siete) R)p) <br /> PHONE: tel) VZ 7 <br /> r i <br /> ' I <br /> I <br /> Ppo9 i <br /> !11 23 041 (Rwhod 1-10. 22) <br />