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SA JN SAN COUNTY PUBLIC HEALTH SEIZGICES <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 OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 310 S. American St , Stockton, CA 95202 <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE GeoAnal tical Laboratories <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION 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 /> The City of Stockton — RDA <br /> BUSINESS NAME: <br /> (If Applicable) <br /> OWNER/OPERATOR: The City of Stockton — RDA <br /> (P P ' ) =2� (Titl ) <br /> (Owner/Operator Signature) (Date) <br /> ADDRESS: 305 N. E1 Dorado St . <br /> (ti'ailing Address) <br /> Stockton, CA 95202 <br /> (City) (State) (Zip Code) <br /> PHONE: ( 209 ) 937-832Q <br /> EH 23 046 (Revised 08/13/99) Page 9 <br />