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SAN'JOAQUIN COUNTY;PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209}468-3420 <br /> AUTHORIZATION TO. RELEASE <br /> * ANALYTICAL RESULTS <br /> * GEOTECHNICAL DATA AUG 3 1999 <br /> * :ENVIRONMENTAL/SIT E ASSESSMENT.INFORMATICtNVIRONMENTALHEALTH <br /> ERMITISERVICES <br /> -------------- <br /> I, THE UNDERSIGNED OWNER AND/OR OPERATOR-OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 7j �1 . 3�-5 S. .. Q. C-) .A v SAD +' <br /> {Sneer Address) (ct-) <br /> HEREBY AUTHORIZE W tL L*$S <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY;PUBLIC <br /> HEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION'AS SOON AS IT IS AVAILABLE AND AT THE SAME <br /> TIME IT IS PROVIDED TO ME OR'MY REPRESENTATIVE. <br /> BUSINESS NAME: <br /> (If Applicable) r .h <br /> O W NER/O P ERATOR: (7-ale) <br /> e Pa) <br /> (Owner/Operator Sign=re) (Dare) <br /> ADDRESS: <br /> (Mailing Address) <br /> (City) (State) .{lip Code) <br /> PHONE: O <br /> EH 23 046 (Revised 10119198) Page 9 <br />