Laserfiche WebLink
0 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />SAN JOAQUIN COUNTY <br />Telephone: (209) 468.3420 Fax: (209) 468-3433 <br />AUTHORIZATION TO RELEASE <br />* ANALYTICAL RESULTS <br />* GEOTECHNICAL DATA <br />* ENVIRONME:NTAUSITE ASSESSMENT INFORMATION <br />1, THE UNDERSIGNED OWNER ANI]/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br />LOCATED AT 6426 I;. Haight ,/toad Lodi <br />(Street AeUress) � --- (City) <br />HEREBY <br />AUTHORt <br />Amon Laboratories <br />(Laboratory) <br />TO RELEASE ANY AND ALL ANALYTICAL. INFORMATION TO SAN JOAQLffN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE SAME <br />TIME IT IS PROVIDED TO MSC OR MY REPRESENTATIVE. <br />BUSiT,iESS NAME: Hondo Company, LLC <br />(1fAppltcable) - -- <br />O W N ER/OPERATOR: <br />Bob Lee <br />('I'i1Fe) <br />(ariY7Csperutoi' Slgnulure) (Date) <br />ADDRl SS: PO Box 1007 <br />(htalling Address) <br />Woodbridge CA 95258 <br />(Cit}) (State) (Zip Code) <br />PHONE: ( 209 ) 369-8255 <br />EH 23 046 (Revised 8/3/07) 9 <br />