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I ENVIRONMENTAL HEALTH DEPARTMENT <br /> Telephone:(2 09)468-3420 Fm(2 09)468,Il,3433 <br /> AUTHORIZATION TO RELEASE <br /> ANALYTICAL RESULTS <br /> C I' 371•:c:I PNCC L DATA <br /> ENvTRoNtvtF.N*rAIJ.%1'11*A%sv—JSMENTMFORi%fATION <br /> `17111131% FRSI D O IVOR OPERATOR Of PROP `1`YA1+UDI`t?1t FACH.rry <br /> ktkeaok <br /> LOCA'i'Fi' AT Pal <br /> 'RI-11Y <br /> AUTIMP 733-- <br /> ( tart) <br /> Yt <br /> To 1=. ANY AND ALL ANALYTICAL WFORMATION TO SAN JOAQUIN COUN'Ilf <br /> Intr HEAT{TIT T1T';PART ENT ' SCx7N AS TT IS ASIA LF.A AT THE SAME <br /> Taili I' IS PROVIDED TO ME OR MY RE TA'11 W <br /> BMJ Is DAME: p F -ND 000 <br /> �. <br /> taF Si stews} P13rzta: <br /> ADDR _ — <br /> (I finh RV"f <br /> d`lit,C ) <br /> E1123 (Revised 1 02) <br />