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��iTJ 1 <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DMSION <br /> (209) 468-3420 <br /> I <br /> AUTHORIZATION TO RELEASE <br /> * ANALYTICAL. RESULTS <br /> * GEOTECHNICAL DATA <br /> * ENVIRONMENTAL./SITE ASSESSMENT INFORMATION <br /> M <br /> I, THE UNDERSIGNED OWNER ANDiOR OPERATOR OF THE PROPERTY'AND/OR FACILITY <br /> LOCATED AT 8709_ N. Davis Rd. , Stockton , CA 95209 <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE GeoAnalytical, 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 /> BUSINESS NAME: Nor.th ,Stockton Auto Service <br /> (If Applicable) <br /> OWNER/OPERATOR: Ed Njemann Owner <br /> Please Print) (Title) <br /> { <br /> (Owner/Operator ign=re). (Dare) <br /> ADDRESS: 5709 N— Davis .Rd. ' <br /> (Mailing Address) <br /> Stockton , CA 952Q9 <br /> (City) . (Stare) (Zip Cade) <br /> PHONE: { 2nq ) 478 1614 <br /> EH 23 046 (Revised 10/19/98) Page 9. , <br /> i. <br />