Laserfiche WebLink
RECD I V E D <br /> SATs )OAQUIN CO[.qtT f PUBLIC HEALTH SERVICES <br /> ETfVIROi~'triEN. TAL HEALTH DrV1SION OCT 2 9 '1996 <br /> (209) 468-5420 ENVIRONMIENTAL HEALTH <br /> PERMIT 1 SERVICES <br /> A-UTHORIZATION TO RELEASE <br /> .-LYTC .L RrSUL i S <br /> - C7,:ji CHN`]CAL. DATA <br /> ASSESSIT iNFCR�1AT10N <br /> 1, <br /> T T 1.'1,"DER51GNED Ot;iNF.R ,;,\Di0R OVER.-.3 0 R OF THE ?FcOPERTY AND/OR FAC;Li T <br /> L CC.-.T7-D ..T 2353 Toste Road , TRac- , CA 9537 <br /> (S.rttr <br /> HER-EBY AU i HOI iU E :SCCG�n > > k a i , - i � � r <br /> {L:`cr-.rc ry} <br /> TO :SEL-EASE A-NY r,ND A.LL 'IT"C.-L iNFC.-�_MA i:ON TO SAN )OAQUA! COUTiTY ?U12L:C <br /> ..�.4l..i SERVICES-EI�-LROi``'yfE'�T.�L 'ri �.L i� ;•i J15'ON .?5 SOCK A5 i i ]5 r+V?.II�.BLE �\`D ;,T i r.E SAME <br /> TIME iT iS FRO\iDED TO ME OR 1.1Y R PR`SENT'.a`iY�- <br /> E-USLN-ESS NAME: <br /> p1� i:c;=,ieJ <br /> O','v-:\'ERIOFER.-kTOR: -',7oe T ?r Pro, =;o• <br /> r':-�:aJ ru1eJ <br /> ,l 710 9 <br /> PC'' <br /> ADDRESS: 22420 Toste Road Trac CA 95376 <br /> 0. d.rESS} <br /> (C:r J (Starr} r+'n Coca <br /> PHONE: ( 209 } 835-5599 <br /> EH 23 096 (Revisd 7110190 Pa�� 9 <br />