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p 2-o 131 <br /> SITEGATION ACKNOWLEDGMENT/REQUEST FOR SERVI CEM �� <br /> SAN JOAOUIN TY - PUBLIC HEALTH SERVICES/ENVIRONMENTAL TH DIVISION <br /> SITE INFORMATION <br /> THER LEAD AGENCY CVRWQCB <br /> Defense Distribution Region West-Tracy <br /> ITE NAME CPT. AGENCY CONTACT James Taylor <br /> Investigation <br /> PHONE 1 (916) 255-3065 <br /> OGRESS 25600 South Chrisman Road APN u 252-07-01,02 & 250-20-06 <br /> ITY Tracy, CA IP 95376 <br /> BILLING / RESPONSIBLE PARTY INFORMATION <br /> AME Montgomery Watson <br /> AILING ADDRESS 4525 South Wasatch Blvd, Ste 200 <br /> ITY Salt Lake City TATE UT IP 84124-4799 <br /> ONTACT NAME Gary Enloe DHONE (801) 272-1900 <br /> PROPERTY OWNER/OPERATOR <br /> AME Defense Logistic Aizenev (contact Marshall Cloud NONE 209 982-2086 <br /> OGRESS DDRW-Sharpe, Roth Road, Lathrop, CA - PO Box 96001 <br /> ITYStockton TATE CA IP 95296-0250 <br /> CLIENT INFORMATION (IF DIFFERENT FROM OWNER/OPERATOR) <br /> AME same as above HONE <br /> DDRESS <br /> TY TATE IP <br /> AUTHORIZATION TO RELEASE/BILLING ACKNOWLEDGEMENT <br /> 1, THE UNDERSIGNED OWNER, OPERATOR, CLIENT, OR AGENT OF SAME, OF THE PROPERTY LOCATED AT THE ABOVE SITE ADDRESS HEREBY <br /> AUTHORIZE THE RELEASE OF ANY AND ALL ANALYTICAL RESULTS, GEOTECHNICAL DATA AND/OR ENVIRONMENTAL/SITE ASSESSMENT INFORMATION TO <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES, ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS <br /> PROVIDED TO ME OR MY REPRESENTATIVE. <br /> ADDITIONALLY, I, THE UNDERSIGNED OWNER, OPERATOR, CLIENT, OR AGENT OF SAME, ACKNOWLEDGE THAT ALL SITE AND/OR PROJECT SPECIFIC <br /> PNS/END HOURLY CHARGES ASSOCIATED WITH THIS ACTIVITY WILL BE BILLED TO THE PARTY IDENTIFIED ABOVE AS THE "RESPONSIBLE PARTY". <br /> APPLICANT'S NAME, TITLE, SIGNATURE/DATE <br /> pME Nancy Barnes, R.G. ISSO <br /> SIGNATURE IIATE 1 3-31-94 <br /> OMPANY Montgomery Watson ITLE Hydrogeologist <br /> 89.007(IV)12/90BILFRMI2 <br />