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SAN JOAQUIN COUNTY 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 OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 103 North E Street Stockton <br /> (Street Address) (city) <br /> HEREBY AUTHORIZE Columbia Analytical <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 /> BUSINESS NAME: A. Teichert & Son, Inc. <br /> (If Applicable) <br /> OWNER/OPERATOR: George Takemori Project Engineer <br /> (Please <br /> Print) <br /> (Title) <br /> / -C — 12-1-98 <br /> ( ner/Operator Signature) (Date) <br /> ADDRESS: P.O. Box 15002 <br /> (Mailing Address) <br /> Sacramento CA 95851 <br /> (City) (State) (Zip Code) <br /> PHONE: ( 916 ) 386-6916 <br /> EH 23 046 (Revised 10/19/98) Page 9 <br />