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91195a @9:03 12@98:322 WRIGHT ENVIRONMENTAL PAGE 04 <br /> SAN JOAQUIN COUNTY PUBLIC nAtTH SERVICES <br /> ENvmoNMENTAL HEALTH DIVIWON ' <br /> I (209)468-34M <br /> AUTHORIZATION TO RELEASE <br /> H <br /> ANALYTICAL RESULTS <br /> f <br /> M GEOTEC KNICAL DATA <br /> i� <br /> ENVIRDNMENTAL/SITE ASSESSMENT INFORMATION <br /> iF <br /> {1 <br /> I. THE UNDEsLSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND10R FACILITY <br /> LOCATED AT <br /> Smea Ad& } (Cry) <br /> HEREBY AUTHOR= <br /> (Iaboraeory) ;r <br /> TO RELEASE ANY AND ALL ANALYTICAL 24FORMATION TO SAN'JOAQUIN COLTN=PUBLIC <br /> Ef <br /> HEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME <br /> �s <br /> TIME IT IS PROVIDED TO ARE OR MY REPRESENTATIVE. <br /> it <br /> BUSINESS NAME: _ <br /> (ff AppfiWbig) G 44_k <br /> OWT WJOPERATOR: <br /> ( r=e PrinW � i <br /> �— - it <br /> ({)araerlOperator Signa�urt} i <br /> pate) <br /> ADDRESS: <br /> Waiiing Address} <br /> (City) rrm Cade} <br /> PHONE: {ZOq <br /> _ a <br /> s� <br /> - !4 <br /> EH 23 046 (Revised 9111196) Page 9 <br /> it <br />