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ECONO LUBE N TUNE Fax:714-851-4810 Oct 1 '04 11:07 P.01 <br /> SAN TOAQUIN COL'N'IY <br /> ENV.fROI,;!N TAL HEA,LMA DEPART14M tr <br /> (209)468.3424 <br /> AtTMORIZATION TO RELEASE <br /> ANALY'.t"ICAL n'sULTS <br /> *GLOTECUMCALDATA <br /> * Y;1 N-MONMENTASJSITE ASSESSMENT 2'MORMA'aON <br /> T,THE'(NDWIONED OWNER AND/OP,OPEFWTOR OF THE PP-OPER.TY ANDJOR FAC2'ITY <br /> LOCATED AT c . ' ; L + <br /> (Street Address) <br /> HEFEBY AUTHORIZE <br /> (�abaratary) <br /> TO RELEASF.kNY AND ,,LL,NALYTIiLAZ�ORv1ATIQN TO SA.^t JOAQU7N%Oif1�'TY Iii VJP OtrTi�6hTT AL IMAL 2 <br /> DEPARTMENT AS SOON AS IT IS AVAILABLE AND <br /> AT THE SAME <br /> TWE IT IS PF'OVIBED TO ME OR.My <br /> REPU <br /> B'CTSVESS NAME: <br /> (7f Applicable) <br /> �ay al <br /> O'WNER/OPMA.TM Ci <br /> (Please Print) (Title) <br /> C, aA <br /> v (OvsnerlOperat®r Signawre) {Dae) <br /> ADDRESS: _— 'j a I �✓2 G I;r SY, lv e 7J <br /> (mailing Actress) <br /> ( (State) (gip Cade) <br /> FAON,E-C ) <br /> EH 23 046 devised 10116iD3) ?EEC 9 <br />