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SAN JOAQUIMCOUNTY 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 AMD/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 2191 Navy. Dr. Stockton, Calif. <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE <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. Mel Bokides Petroleum Inc . <br /> (If Applicable) <br /> OWNER/OPERATOR: Nick B o kt i d est M r . <br /> (Please Prinz) <br /> (Owner/(Aerator gnature) (Date) <br /> ADDRESS: same <br /> (Mailing Address) <br /> S ock on a i 95201 <br /> (City) (State) (Zip Code) <br /> PHONE: (_209_943-2011 <br /> EH 23 046 (Revised 9/11/96) <br /> Page 9 <br />