Laserfiche WebLink
JOAQUIN COUNTY PUBLIC HEAL VICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209)468-3420 <br /> AUTHORIZATION TO RELEASE <br /> *ANALYTICAL RESULTS <br /> *GEOTECHNICAL DATA <br /> *ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I,THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT Corral Hollow Road. Tracy. California <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE Clayton Environmental Consultants <br /> (Laboratory or Consultant) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC HEALTH <br /> SERVICES AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED TO ME OR MY <br /> REPRESENTATIVE. <br /> BUSINESS NAME: Lawrence Livermore National Laboratory <br /> (If Applicable) <br /> OPERATOR: Charlene Grandfield, Operator. Deputy Division Leader <br /> (Please Print) (Title) <br /> a �",jj <br /> (Operator Signature) <br /> ADDRESS: 7000 East Ave.. P.O. Box 808 <br /> (Mailing Address) <br /> Livermore. CA 94550 <br /> (City) (State) (Zip Code) <br /> PHONE: (510) 423-6577 <br /> DATE: —lo—7- ) <br /> EH 23 041 (Revised 7/10/92) <br /> 9 <br />