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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (709) 468-3420 <br /> AUTHORIZATION TO RELEASE <br /> • ANALYTICAL RESULTS <br /> • GEOTECHNICAL DATA <br /> • ENVIRONMENTA4SITE ASSESSMENT INFORMATION <br /> I, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 315 F . 11th Street Tracy <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE CKY Cnvironmental Laboratories or Sparger Tech . <br /> (Laboratory or Consultant) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> HEALTH SERVICES AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED <br /> TO ME OR MY REPRESENTATIVE <br /> ~� BUSINESS NAME: Tracy Public Schools <br /> (If Applicable) <br /> OWNER/OPERATOR: Ms . Anne BeLl A. <br /> (Please Prior (Title) <br /> :e � <br /> (Owner/Operator Si cure) v <br /> ADDRESS: 315 C. 11th Street <br /> (Mailing Address) <br /> Tracy, CA 95376 <br /> (City) (State) (Zip Code) <br /> PHONE: ( 209 ) 831-5032 <br /> DATE: December 7 , 1993 <br /> GH 23 041 (Revised 7-1492) Page 9 <br />