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11/02/2001 10:47 9166813&21 GEOFON INC PAGE 11 <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEAL'T'H DIVISION <br />(209) 46B-3420 <br />S <br />* ANALYTICAL RESULTS <br />* GEOTECHNICAL DATA <br />* ENVIRONMENTALISITE ASSUSMENT INFORMATION <br />it THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY ANDIOR FACILITY <br />(City) <br />HEREBY AUTHORIZE <br />TO RELEASE ANY AND ALL, ANALYTICAL INFORMATION TO SAN IO,AQUIN COUNTY PUBLIC <br />HEALTH SERVICES -ENVIRONMENTAL 14EAL 14 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 />OWNERIOPERATOR: <br />(OwnerlOperator Signature) <br />• }` ` WJU <br />rr�} ,,•.����yy(City) <br />PHONE: C„�L ) <br />EH 23 046 (Revised 08113/99) <br />Page 9 <br />N <br />