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C� <br />SAN JOAQUIN (AUNTY PUBLIC HEALTH SERVICES <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 OPERE.TOR OF THE PROPERTY AND/OR FACILITY <br />LOCATED AT 650 E. MINER AVENUE, STOCKTON, CALIFORNIA 95202 <br />(Street Address) <br />HEREBY AUTHORIZE SEQUOIA ANALYTICAL <br />TO RELEASE ANY AND ALL ANALYTICAL INrORMATION TO SAN JOAQUIN COUNTY PUBLIC <br />HEALTH SERVICES -ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME <br />TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br />CAPITOL AUTO SALES <br />i7iF`1 t►1 �`IY`J.\u ty <br />(If Applicable) <br />OWNER/OPERATOR: JAGENDER SINGH <br />(Please Print/)n/ (Title) <br />7/Z <br />>/ 2 7 /0 <br />650 E. MINER AVENUE <br />ADDRESS: <br />(Mailing Address) <br />STOCKTON CALIFORNIA 95202 <br />(City) (State) (Zip Code) <br />PHONE:(209 ) 466 9082 <br />EH 23 046 (Revised 10/19/98) Page 9 <br />