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SAN * UIN COUNTY PUBLIC HEALTH SERV <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209) 468-1420 i <br /> AU'I'IIOIZI7A'I'IO[V TO RELEASE <br /> I <br /> I <br /> I <br /> " ANALYTICAL RESULTS <br /> " GEOTECIINICAL DATA <br /> " ENVIRONMEN'TAUSIIE ASSESSMENT INFORMATION <br /> I <br /> I, 111E UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATFD AT 3230 N. West Lane , Stockton , CA 95204 <br /> (Street Address) (City) <br /> IIERFBY AUIIIORI7_E (Street <br /> Laboratories <br /> (Lnhnrntnry) <br /> 10 RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> IIEA1,111 SERVICES-ENVIRONMENTAL HFALiA DIVISION AS SOON AS IT IS AVAILABLE AND AT THB SAM& <br /> 11h1E IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: Van De Pol Enterprises <br /> (IJ Applicable) <br /> OWNER/OPFRATOR: Van De Pol Enterprises, Owner <br /> (/least Print) p7dtJ <br /> r <br /> 9/15/98 <br /> (Ulrner/Operator Signnmre) `" (Dort) <br /> ADDRESS: p.0� gox_ 1.107 <br /> (MeiNng Address) <br /> Stockton, CA 95201-1107 <br /> (city) (Stare) (LIp Code) <br /> PIIONE: ( 299 ) ARFi-5921 <br /> 41 23 046 (Revised 9111/96) Page 9 <br />