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MAY -07-2002 TUE 06:48 AM G&AILER RYAN INC <br />,/2002 10:09 2094683,' <br />FAX N0. 793218 <br />FIFTH FLOOR <br />SAN J'OAQ'UIN COUNTY <br />ENVIRONMENTAL HEALTH DEP,ARTME F <br />(209)468-3420 <br />AUTHORIZATION TO RELEASE <br />` ANAC,YTICA.L RESULTS <br />* GEOTECINICA.L DATA <br />* ENVMC)NWNTAL/SITE ASSESSMENT l'NFORNi4TZON <br />I, THE UNDERSIGNLD OWNER AND/OR OPERATOR OF TXM PROPERTY AND/OR I^AMITY <br />AT <br />15" W- [.ice <br />(Street <br />(Cyr') <br />P, 02 <br />PAGE 0 <br />HEMY AtTI'Y-YORIZE <br />Ki Fr t ria L. KwF C ~3o cRi - 41300 <br />TO R1ELF— ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONMENTAL HEALM <br />DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE SAME <br />TIME IT IS PROVIDED -to ME OP MX REPRESENTATIVE. <br />BUSYNESS ]�,'�IvIE <br />(if Applicable) <br />OWNEWOPERATOY2.; <br />Nl #` G I-.) yAA7 A7G <br />.--� (Please Print) <br />(Owner/Operator Signature) <br />ADDRESS,► -6%, P, Me—mwcz IZLVD <br />(A9aihPX Address) <br />{Dnte) <br />�,,--� {C&Y) (srate) (Zip Code) <br />PHONE: C) �% � ` '3 Zee► �a <br />F -H 23 046 (Revised 2/24/02) Page 6 <br />2 <br />JAN 25 '02 9:13 2094653433 PAC>=.Z5507 <br />