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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Teleph one: (209)468-3420 Fax: (209)468-3433 <br /> AUTHORIZATION TO RELEASE <br /> ANALYTICAL RESULTS <br /> GEOTECHNICAL DATA <br /> • ENVIRONNIFNTAUSITE ASSESSMENT INFORMATION <br /> I.THE UNDERSIGNED OWNER AND:OR OPERATOR OF THE PROPERTY AND-OR FACILITY <br /> LOCATED AT 3 East Eleventh Street Tracy-CA <br /> IS:reef dddmys) (01"1 <br /> HEREBY <br /> AUTHORIZE Precision Enviro-Tech,Stockton,California_ <br /> (I abanrw,�W <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE SAME <br /> TimE IT IS PROVIDED TO NIE OR MY REPRE=SENTATIVE. <br /> BUSINESS NAR1E: Levand-Bright Properu/ <br /> OWNEROPERATOR. Louis Levand Trust.Et.al. Paula Levand.Trustee <br /> (Or,, 7 <br /> nm�pu stol'Sn n.:(url JD.:rel <br /> ADDRESS. 24692 Sand Wedge Lane <br /> l.11aihm!:hk,a�1 <br /> Valencia CA 91355 <br /> (Cint IStufe) (7irr CudO <br /> PHONE:i 661 ) 904-2133 - <br /> Eli'3 o-1G IRc•:isrd 5r Ulti S <br /> SAN JOAQCIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> SERVICE REQUEST <br /> Type of Business or Property FACILITY IB: SERVICE REQUEST C <br /> Vacant I��''jI�� <br /> OWNERIOPERATOR ChECKRBIILNDADD" [a <br /> Louis Levand Trust Et.al.,do M5.Paula Levand <br />