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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 /> ENVIRONMENTALlSITE ASSESSMENT INFORMATION <br /> I, THE L;NDERSLG`EJZ2sN_`:Z-R Ac�tOR OPERATOR OF THE PROPERTY AND/OR FACILITY" _ <br /> LOCATED AT 445 E. Fremont St . , Stockton, CA 95202 <br /> (Streer Address) (City) <br /> HEREBY AUTHORIZE GeoAnalytical Laboratories <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUN COUNTY PUBLIC <br /> HEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME f <br /> TLVIE IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br /> The City of Stockton <br /> BUSINESS NAME: <br /> (If Applicable) ) <br /> OWNEROPERATOR: The City of Stockton <br /> (Fl Print (Title) <br /> er/ Aerator Si;nature) (Date) <br /> ADDRESS: 445 N. E1 Dorado St . , f <br /> (Mailing Address) <br /> Stockton, CA 95201-1997 <br /> (City) (State) (Zip Codej <br /> PHONE: 209 937-8358 <br /> ( ) <br /> EH 23 046 (Revised 08/13199) Page 9 <br />