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FARMES. INSURANCE 209 399 3421 r n• <br /> SA,,,,OAQMX COUNTY PUBLIC HEALTH SEK_JCES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209)468.3420 <br /> AUTHORIZATION TO R$f.F.ASE <br /> • ANALYTICAL RESULTS <br /> • GEOTECM41CAL DATA <br /> • ENVIRONME4TALh5ITEASSESSMENTINFOWMATION <br /> I,THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 2851 East Eight Mile Road Lodi, CA 95240 <br /> (Street Addreut) (City) <br /> HEREBY AUTHORIZE Geoanalytical Laboratory <br /> (Labamt,wy or Camukarg) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAOULTI COUNTY PUBLIC <br /> HEALTH SERVICES AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME Stockton/Lodi ROA*Rampgrounds <br /> (IJAppllcable) <br /> OWNER/OPERATOR: Ut(I f I (a V" E5a,Iers0rt Coir.-t- <br /> (Plena Prnt) fry) <br /> (a"erloperatar Sipat re) <br /> ADDRESS: 17881 Giennwood Drive <br /> (MauLlW Ad&c=) <br /> Manteca, CA 95336 <br /> (may) -- (State) (Zip code) <br /> pHpNg 209^- 823-4930 <br /> DATE: <br /> EK Zi 041 (RevlseA 7-10-92) Past 9 <br /> 11-01-1994 04:46PM 209 599 5421 P.01 <br />