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SAN�AQUIN COUNTY PUBLIC HEALTH S-mk<VICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209) 468-3420 <br /> AUTHORIZATION TO RELEASE <br /> • ANALYTICAL RESULTS <br /> • GEOTECHNICAL DATA <br /> • ENVIRONMENTALJSITE ASSESSMENT INFORMATION <br /> 1, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> er Lane Stockton <br /> LOCATED AT Hardin Way, 1/4-mile west of Bey (City) <br /> (Street Address) <br /> HEREBY AUTHORIZE Se uoia Analytical <br /> (laboratory or Consultand) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN 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 /> Federal Emergency Management Agency (Acting on behalf FCC) <br /> BUSINESS NAME: g y <br /> (If Applicable) <br /> 21 <br /> O\VNTER/OPERATOR: X �y/�� ��/G/Y/��_41 Zd Ut,0 � ��lNH L�A <br /> (Please Print) (Title) <br /> (Owner/Operator Signature) <br /> ADDRESS: Chief, Facilities and Equipment Branch, 500 C St. , S .W. <br /> (Alailing Address) oom <br /> Washington, D.C. 20472 <br /> (City) (State) (Zip Code) <br /> PHONE: ( 202 ) 646-3061 <br /> DATE: 9/29/93 <br /> EH 23 041 (Revised 7.10-92) Page 9 <br />