Laserfiche WebLink
WALTONENGINEERING 91640611 P. 10' <br /> I) <br /> MAR 15 '93 03:21PM ULTRAMAR INC. F,10,,16 f <br /> t <br /> I <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH D[VISION <br /> (209) 468-3420 <br /> AUTHORIZATION TO RELEASE <br /> • ANALYTICAL RESULTS <br /> • GEOTECHNICAL DATA <br /> " ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I, THE UNDERsIONED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT Z-3 G✓•�T c. L-fw "�D S �< 1G —a ,1 <br /> (S rear Addreu) (Cay) <br /> HEREBY AUTHORME <br /> aabvmar or Coeeubmrr) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> HEALTH SERVICES AS SOON AS TT IS AVAILABLE AND AT THE SAME TDAS IT IS PROVIDED <br /> To ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME' 1� l �rx r .AC <br /> (ur�yiicable) <br /> OVJNER/OPERATOR: <br /> ) (Title) <br /> ( wner/Opastai Sipalwo) <br /> ADDRESS: 5. <br /> (Mailing Addws) <br /> 140�z- /f <br /> (cay) (Sidle) f..t� (Z CW-*) <br /> PRONE: (,0;k0c( <br /> DATE: J <br />