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&IIN JOAQ11111 CO*A rTFIDEM.973—TiN SERVICM <br />ENVIRONMENTAL HEALTH DIVISION <br />(209) 468-3420 <br />* ANALYTICAL RESULTS <br />* GEOTECHNICAL DATA <br />ITOTOMTOW4, I <br />(Street Address) (City) <br />HEREBY AUTHORIZE T,6V-- LAV-6&A- <br />(Laboralmy or Conniftant) <br />TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br />BUSINESS NAME:E� MoJI fAAP,-T <br />KA 4-�� <br />(If Applicable) <br />OWNER/OPERATOR: �TgC,�, MZ2� <br />,,--)(Please Print) /I -/ (Title) <br />Signature) <br />6KACbfJ ?63�Lo <br />(city) (State) (Zip Code) <br />DATE: <br />EH 23 041 (Revised 7-10-92) Page 9 <br />