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07/13/1993 10 12 orZ SERVE PETR. MKTG 713 • 0737 P.01 <br />I <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />(209) 4683420 <br />AUTHORIZATION TO RELEASE <br />• ANALYTICAL RESULTS <br />• GEOTECHNICAL DATA <br />• <br />-+-•., v .wvi..,lvlCit i L•+t'Vit1yA'1'ION <br />I, THE UNDERSt"ELD OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br />LOCATED AT Jp. �TOG�"j�f•I <br />1 f� <br />HEREBY AUTHORIZE l tel') <br />TO RELEASE ANY AND ALL ANALY77CAL, INFORMATION USAN JOAQUIN COUNTY PUBLIC <br />HEALTH SERVICES AS SOON AS IT IS AVAILABLE AND AT THH SAME TIME IT IS PROVIOLD <br />TO ME OR MY REPRESENTATIVE <br />BUSINESS NAME Ptc <br />(U�PPucable) <br />OWNER/OPERATOR- (� <br />(,pk4m priv) (mak) <br />(ZIP <br />PHONE. <br />DATE: <br />Xi 23 041 (IWvkW 7.10.92) Pop 9 <br />Ek <br />