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11167!2002 11:32 21.,14-f FIFTH FLOOF: PA6E 07 <br /> SAIF JOA.QUIN COUNTY <br /> EN'VIROWENTAl. HEALTH DEPARTMENT <br /> (209)46$-3420 <br /> AUTHORIZA-RON TO RELEASE <br /> * <br /> ANALYTICAL RESULTS <br /> `GROTECHNICAL DA'T'A <br /> Eh'Vll�-QNMENTAL/STYE ASSESSMEN-r rNF©RNIATION <br /> I,THE UNDkRSIGATED OWNER ANDIOR OPERATOR OF TGIF PROPERTYA'm P,FACILI�Y <br /> LOCATED AT K,Lu ur '11 �'t7�.i Z i r4 C. <br /> IEREI3Y AUTHOPJ7,E <br /> (�-uhotutory} <br /> To RF-LEASE AI7y AND ALL ANALYTICAL Il FFORMATION TO SAN JOAQUINT COUNTY ENVjRQ,NMEENTAL HEALTH <br /> DEPARTMENT AS SODN AS IT IS AVAILABLE AND AT THE SAAJE <br /> TIME IT IS PROVIDED TO h41J OR MY RFPRESEA'TATTVt. <br /> BUSINESS NAMY;: � •F� �.�_.V � � ��{'-.',� g 1 Its r r <br /> (ffAppli.bjL,) <br /> OWNER/OPE aTM <br /> (Pi iasc Print) itic) <br /> (�►v��rrnex'14Perat9z',signature) (fJQTEJ <br /> ADDRESS; �•C7• � T" I �� <br /> (A�ailirt�Address <br /> lGft� (State) <br /> EH 23 046 (ReviSe.d 1/24/02) <br /> b <br />