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DISC 8022A II/wl <br /> FPA!]00-22 <br /> 1r V <br /> Aug 02 01 08: 384 TEC RCCUTI15 650 352-7631 p-2 <br /> SAN JOAQUIN ENVIRONMENTAL HPUBLIC <br /> EALTH D V SION V1CF'S <br /> (209)469.1420 <br /> AUTHORIZATION TO RELEASE <br /> 4 ANALYTICAL RESULTS <br /> A GEOTECHNICAL DATA <br /> • L•:NVIRONMENT'ALISITE ASSESSMENT INFORMATION <br /> 1,THE UNDERSIG((N��EO OWNER AND/OR OPLRATOR OF THE PROPS-�7/T�\y-�A�ND/OR F`9C�lL}TY <br /> LOCATEDAT AS-0 Ea.s-� <br /> � {Street dQrttt) ` <br /> HEREBY AUTHORIZE �J ,4 <br /> (labarmoryl <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> HEALTH SERV ICES-ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT 15 AVAILABLE AND AT THE SAME <br /> TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME <br /> ^y dfAppllcable) <br /> OWNERIOPERATOR. _ 'T��Pr�-J/�/Q ae— &0-� <br /> 1 ' <br /> (Owner. Operator Sl$nnlu (tl e1 <br /> i ADDRESS: � �U c� © I�S <br /> (Mauling Addcelt) <br /> (c y� 1 <br /> (star— ti fp coda <br /> PHONE:( 0 )_1 1 (Oil <br /> 1 EH 23 046 (Rc9iwd 08/13/99) Page 9 <br /> i <br /> 2'd 269'ON 1d3Q A1I-IIJHd '3 AN3 WdEC:I T002'2 *%IU <br />