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SIT' TICAT)ON ACKNOWLEDGMENT/RECUEST FOR SERVI IRM <br /> SITE INFORMATION <br /> SAN JCAOUINNTY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL .LTX DIVISION <br /> THER LEAD AGENCY RVrCB <br /> IiE NAME Santa Fe Pacific Pipelines AGENCY CONTACT P. Isorena <br /> Stockton Terminal <br /> PHONE 1 <br /> CORESS APN At <br /> 2947 Navy Drive —J <br /> "Y Stockton, California IF 95206 <br /> BILLING / RESPONSIBLE PARTY INFORMATION <br /> aME Santa Fe Pacific Pipeline Partners, L.P. <br /> IL1NG ADDRESS 888 South Figueroa Street <br /> ;TY Los Angeles STATE CA IzIP 1 90017 <br /> CNTACT NAME James Holland DHONE (213) 486-7947 <br /> PROPERTY OWNER/OPERATOR <br /> AME Same as Billing/Responsible Part HONE <br /> CRESS <br /> ITY TATE IP <br /> CL:E4T INFORMATION ()F DIFFERENT FROM OWNER/OPERATOR) <br /> AME HONE i <br /> f <br /> DORESS <br /> ;TY TATE IP <br /> AUTHORIZATION TO RELEASE/BILLING ACKNOWLEDGEMENT J S L. 1 4 1992 <br /> 1, THE UNDERSIGNED OWNER, OPERATOR, CLIENT, OR AGENT OF SAME, OF THE PROPERTY LOCATED CIY Vif�Vl'I7Vi1VfHL I'ii.r4 §8�7y <br /> AUTHORIZE THE RELEASE OF ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA ANO/OR ENVIRONMEK&kits Al EER�1E)LT ..61FORMATION TO <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES, ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS <br /> PROVIDED TO ME OR MY REPRESENTATIVE. <br /> ADDITIONALLY, 1, THE UNDERSIGNED OWNER, OPERATOR, CLIENT, OR AGENT OF SAME, ACKNOWLEDGE THAT ALL SITE AND/OR PROJECT SPECIFIC <br /> PHS/EHO HOURLY CHARGES ASSOCIATED WITH THIS ACTIVITY WILL BE BILLED TO THE. PARTY IDENTIFIED ABOVE AS THE "RESPONSIBLE PARTY". <br /> APPLICANT'S NAME, TITLE, SIGNATURE/DATE <br /> AME P n .. - ... SX <br /> IGNATURE / ATE 7131/1 <br /> CMPANY )-art Crowser, Tnc. InE Project Geologist <br /> a & <br /> 89.007(IV)12/908ILFRMI2 A- <br />