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Sent By: Equiv2 services LLL;; yeD J7/ <br />Wednesday, March 20, 2041 10:29 AM vwwlFESteroo.eom (209} 049.4559 <br />SAN )OAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />(209) 466 3420 <br />AUTHORIZATION TO RELEASE <br />4 ANALYTICAL RESULTS <br />• GEOTECHNICAL DATA <br />• ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br />1. THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br />✓ p,03 <br />LUCATED AT `� ? � ff> -1 co (t.�� `�' C� � -�` v <br />(Sired Address) (CirYJ <br />HEREBY AUTHORIZE _--�.A aA fl,% <br />flAvertrlory) <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 />TIMI 11* IS PROVIDED TO ME OR MY REPRESENTATIVE, <br />BUSINESS NAME: <br />OWNER/OPERATOR: <br />�_G�0NLj--> r-11 € <br />(If Applicably) <br />(Please Print) <br />(6vojj4lQ2ffjW Signature) <br />S C U—. C-' <br />pitic} <br />Mule) <br />ADDRESS: 1 `\2.._b Gen <br />(Halling Address) <br />(City) <br />PHONE: ( �-) <br />EH 23 D46 (Revi$cd 08/13/99) Page 9 <br />CS.7.: <br />Code) <br />