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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 <br /> AUTHORIZATION TO RELEASE RECEIVED <br /> J <br /> EP 15 2015 <br /> * ANALYTICAL RESULTS ENVIRONMENTAL. <br /> * GEOTECHNICAL DATA HFAITN r)GpARTAACKIT <br /> * ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I,THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 800 East Main Street Stockton, CA 95202 <br /> (Street Address) (City) <br /> HEREBY <br /> AUTHORIZE Precision Enviro-Tech of Stockton, California <br /> (Laboratory) <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 ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: City of Stockton <br /> (If Appl icable) <br /> OWNER/OPERATOR: City of Stockton, Public Works Assistant Engineer <br /> (P eas Print) (Title) <br /> 49hq <br /> wn /Operator Signature) (Date) <br /> ADDRESS: 22 East Weber Avenue, Room 301 <br /> - (Mailing Address) <br /> Stockton CA 95202 <br /> (City) (State) (Zip Code) <br /> PHONE: ( 209 ) 937-8374 <br /> EH 23 046 (Revised 07/17/14) 8 <br />