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DocuSign Envelope ID: 3E840329-DB85-47BE-9918-A6FA17D075C4 <br />';SNALYTTCAL RESULTS <br />GECJTEC:NN[�'AL DATA <br />JUN 21 2U23 <br />ENVIRONMEf1TA- <br />PERMIT/SERVICES <br />ENS-[RC�NNI�NTAlJSIT ASSESSi\1F,NTINFOIZVIATIC)N <br />I, Tl(Li L!:'�DERSI�i�tf:[� O\StNER !SND/O.R OP)�RATC�R OF THF' PROPERTY :SNDr't.)R [=ACII:ITY' LOCF�T�D ,4T <br />(St'reet AdcJrc�s.r) <br />TTGRT RY AUTHORIZE <br />(L abolvtrtor,t-) <br />TO RELE�'� SE «1v'�' AND ALL ANALYTICAL INFORM TIO%T '1'O SAN JOA�UOJ COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT " HL4 <br />SAME TIME IT IS PROVIDED TO ME OR MY REPF�-ESENTAJ]VE, <br />[3L'SINE:SS N/\iv4E: •� r � `•'' +' / ,.'f/Cr � F°`F 7 ` a <br />t JApplic•ahle) <br />0S\/NL-'RiOPER_~1TC)R: Pedro M. Qui OTT <br />(Ple6oC Pt int) <br />D <br />ocuSigned by: <br />✓ � I .f eo�2o �%�,f�% <br />DB4�FW1rK <br />.pe�-atca€- Si;rtarrn•el <br />(;l�failitrg :4i/dres,rl <br />Admin.of Margaret Ribota Quiroga Estate <br />(Ti t!F i <br />6/20/2023 <br />(Date) <br />(StutF) (Zi�� Cock) <br />