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SITE MOGATION ACKNOWLEDGMENT/REOl1EST FOR SERVICES <br /> SAN JOAOUIN COUNTY . PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIVISION <br /> SITE INFORMATION <br /> THER LEAD AGENCY RW CB Reg. 5 <br /> ITE NAME Defense Distribution Region West-Sharpe AGENCY CONTACT <br /> James Taylor <br /> Proposed pecolation pond and GW treatment areas <br /> PHONE 209 982-2093 <br /> % Area bounded by G Street, 1st Avenue, West Street, <br /> DDRESS and the northern extension of 2nd Avenue APN # 198-020-01 <br /> ITY Lathrop, CA P <br /> BILLING / RESPONSIBLE PARTY INFORMATION <br /> AME James M. Montgomery Consulting Engineers, Inc. <br /> AILING ADDRESS 365 Lennon Lane <br /> ITY Walnut Creek 3TATE CA IzIP 94598 <br /> ONTACT NAME John Chien, Project ManagerHONE (510) 975-3400 <br /> PROPERTY OWNER/OPERATOR <br /> AME U.S. Army (Contact John Guzman) iPHONE 1 (209)982-2093 <br /> DDRESS Defense Distribution Region West, Sharpe <br /> ITY Lathrop TATE CA IP <br /> CLIENT INFORMATION (IF DIFFERENT FROM OWNER/OPERATOR) <br /> AME NA HONE <br /> %DDRESS <br /> ITY TATE P <br /> AUTHORIZATION TO RELEASE/BILLING ACKNOWLEDGEMENT <br /> 1, THE UNDERSIGNED OWNER, OPERATOR, CLIENT, OR AGENT OF SAME, OF THE PROPERTY LOCATED AT THE ABOVE SITE ADDRESS HEREBY <br /> AUTHORIZE THE RELEASE OF ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OR ENVIRONMENTAL/SITE ASSESS14ENT INFORMATION TO <br /> SAN JOAOUIN 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 /> PNS/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 John Chien, PE Gx 494-60-5025 <br /> IGNATURE I-m4a ATE 2/2/93 <br /> OMPANYJames M. Mont omer Consulting ITLE Project Manager <br /> 89-007(IV)12/90BILFRM12 <br />