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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (2W) 468-3420 <br /> AUTHORIZATION TO RELEASE ' <br /> ' - ANALYTICAL RESULTS <br /> 14 GEOTECHNICAL DATA <br /> • ENVIRONMENTAIZITE ASSESSMENT INFORMATION <br /> 1 <br /> 1, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> 1 LOCATED AT <br /> Street Address) 0 1 (Civ) <br /> HEREBY AUTHORIZE �0 c- a z I r C S <br /> boratory or <br /> ' TO RELEASE ANY AND ALL ANALYTICAL INF �ORMATIONTO SAN JOA UIN <br /> Q COUNTY PUBLIC <br /> 1 HEALTH SERVICES AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED . <br /> TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME VALLEY WHOLESALE DRUG CO I INC <br /> (If Appitcable) <br /> OWNER/OPERATOR. LOUIS E SHONEFF CEO <br /> {Ple a (Title) <br /> i <br /> Owner/Operator Sig ure) <br /> ' ADDRESS, 1401 W F R E M 01 NT R <br /> (Marling Address) <br /> 1 (City) (Stare) (Zip Code) <br /> 1 PHONE2�j 466-0131 <br /> 1 <br /> DATE <br /> 5/9/94 <br /> H 23 041 (Revised 7-10-92) Page 9 <br />