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06/25/1938 14:03 408-427-1717 SAN LORENZO LBR 00 ?436 01 <br /> • .7r�n- 2S-3Ct 11 :47A <br /> �`• SAN JOAQUIN COUNTY <br /> ENVIRONh1ENTA1. HCLA0.:1'2 DI"�1Sa7'- <br /> (109) 468.3611, <br /> AUTHORIZATION Tf., i E ,'-: %,'.'` <br /> • ANA.LYTICA). Rk SCLTS <br /> e GEOTECHNICAI•• DATA, <br /> ' ENVIRONMENTALr51TE ASSf::•i§.F,N'1' i^Iri)n}•'? itOP; <br /> 1 THE VNDERSIONED OWNER AND'OROP�P-RA70R OPTHF :PROVe"IT`i t.i'IG%OR FACILITY <br /> LOCATBDAT <br /> (Street Aifdrels) r•- rCrrvl <br /> HEREBY AUTHORIZE _� ,L� ��"S' 5."1'�',_a(.:rlf;.4.^:'• �- . .___-._.. - <br /> (fahoralony <br /> TO P.EVEASE ANY AND ALL ANALYTICAL INFORMATION T'7 SAN PSA 111i177 i:OUNTY FUHL1:- <br /> HEALTH SERVICES-ENVIRONINENTAL HEALTH DIVISION As SOON f 5 i,VAII_.AIJI,E '+ND .'.IT IMF, <br /> r• .'•! <br /> IT IS PROVIDED TO ME OR hfY REPRESENTATIVE. <br /> C� 1 , <br /> BUSINE5S MARIE' LC r, l}.+�-�-G� .eS.e.;C^i: C'.Sc,.,.._..._ <br /> (If Applicable) <br /> i <br /> (.)WNERiOPERATOR: <br /> (Pleose Prino �nrt i <br /> (Owner/UPc signaare) - <br /> 1 - <br /> ADDRESS. � <br /> ( ailing Addressl <br /> -y (city) (Clare) (Zip Code, <br /> PHONE. t�P"QG1 )�, �r'�5 C�'..j`.....__. <br /> EH 23 046 (Revised 9/11196) rigr <br />