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ENVIRONMENTAL HEALTH DEPARTMENT <br />SAN JOAQUIN COUNTY <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 <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 10858 TRINITY PARKWAY, STOCKTON, CA <br />(Street Address) (City) <br />HEREBY AUTHORIZE <br />KIFF ANALYTICAL, 2795 2ND STREET, DAVIS, CA <br />(Laboratory) <br />TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH <br />DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE SAME <br />TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br />BUSINESS NAME: TOWN & COUNTRY CONTRACTORS, INC <br />OWNER. <br />(If Applicable) <br />CHEVRON USA C/O TOWN & COUNTRY CONTRACTORS, INC <br />(Please Print) Itle) <br />%4. 10 <br />(Date) <br />ADDRESS: 3181 LUYUNG DRIVE, STE A <br />(Mailing Address) <br />RANCHO CORDOVA, CA 95742 <br />(City) (State) (Zip Code) <br />PHONE: ( 916 636 9500 <br />EH 23 046 (Revised 02/20/09) <br />5 <br />