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NOU-27-'90 TUE 15:44 ID:WOLIN AND SONS TEL NO:209 267-0261 9610 P02 <br /> 11i27/90 14:08 '0918 38( 13 002 <br /> PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY 1 - <br /> JOG] KHANNA M-D.,M.P.N. <br /> 14oalrk4fficrc — <br /> P_O. Box 2009 • (1601 Eric Hazelton Avenue) • Scucknon,Califurnil 95201 <br /> (209) 468-3400 <br /> ENV I RONAIENTQL HEOLTH D IV_(S I ON <br /> ('209) 468-24cO <br /> pUTHO R I Z C4T Y ON -r C3 RELEASF-=- <br /> 4. ANALYTICAL RESULT: <br /> * GEOTECHNICAL DA-rr4 <br /> * ENVIRONMENI-AL/SITE ASSESSMENT INFORMATION <br /> I9 THE UNDERSIGNED OWNER AND/UR OPERATOR OF THE PROPERTY AND/OR 1=ACILITY <br /> LOCATED AT <br /> (ST FET ADDRESS) (CITY) <br /> HEREBY AUTHORIZE KLG:/LLF��c�'p�-.rle_i'�/G.t_.._..--- -------_. . ...,....---- _- <br /> (LABORATORY or C0tVS1JL rP1Vr) <br /> TO RELEASE ANY AND ALL ANRLYTICAL RESULTS, GEOTECHNICAL DATA ANU/OR <br /> ENVIRONMENTAL/SITE ASSESSMENT IN1=ORMAT10IV TO SAN JOAQUIN COUNTY PUBLIC <br /> I ICALTl 1 CE n V I CES AS SOON (1- IT i s pu c)Y LC3RLE ANTI OT THF I;AMI= TIME 1 r is <br /> PROVIDED TO ME OR MY AEPRESENTAVIVEi. <br /> b USINE5b -_-•,-- <br /> i IF r'7(•'F'LICAPLE> <br /> OWNER/OPERATOR: Qrir9 Aclojo%yt 4- <br /> O%EASE PRINT) f TI7LE) <br /> is.rGNgTURE) <br /> ADDRESS . f0 . Roz --------------- <br /> (MAIL ING PDDRESS) <br /> .. e?_s <br /> (Cl TY) (STATE) i ZIF) <br /> PHONE : r,( 2.67 - 9 l ZZ__— ----- - - -- ---- <br /> DATE: z7 - 9v <br /> L',j In . . - -_ , ^ a <br />