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it <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209) 468-3420 <br /> AUTHORIZATION �TO .RELEASE <br /> * ANALYTICAL RESULTS <br /> * GEOTECHNICAL DATA <br /> * ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> 1, THE UNDERSIGNED OWNER AND/OR ,OPERATOR OF THE PROPERTY AND/OR FACILIT <br /> LOCATED AT ('Dg 11 <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE <br /> (Laboratory) <br /> ��Lrr���ttt TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> CHEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME <br /> TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: <br /> (If Applicable) <br /> OWNER/OPERATOR: N7 b <br /> (PI e e Pr' t) (Title) <br /> L 3 <br /> ( ner Aerator Signature) (Dat4A <br /> ADDRESS: <br /> (Mailing Address) <br /> (City) (State) (Lip Code) <br /> PHONE: ( ) <br /> EH 23 046 (Revised 08/13/99) Page 9 <br />