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0 <br /> 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 2201 WEST WASHINGTON STRLET, STOCKTON CA 95203 <br /> (Street (City) <br /> HEREBY AUTHORIZE <br /> FGLLABORATQRIEB <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: STOCk1'0N PORT DISTRICT <br /> (If Applicable) <br /> OWNER/OPERATOR: BARRY H.- NICHOLSON, ENVIRONN1TiNTAL SPECIALIST <br /> (Please Print) , (T'i'tle) <br /> laIq <br /> (Own r peratorignature) are <br /> ADDRESS: PO 13OX 2089 <br /> (Mailing Address) <br /> STOCKTON, CA 95201 <br /> (City) (State) (Zip Cade) <br /> PHONE: ( 209 ) 946-0246 <br /> EH 23 046 (Revised 9111/96) Pa-ge 9 <br />