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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> (209)468-3420 <br /> AUTHORIZATION T® RELEASE <br /> *ANALYTICAL RESULTS <br /> *GEOTECHNICAL DATA <br /> ENVIRONMENTAUSITE ASSESS O TI <br /> I,THE UNDERSIGNEDOWNER /OR OPERATOR OF THE PROPERTY /O ACILITY <br /> LOCATED AT <br /> (S Address) ( ) <br /> HFY <br /> BY AUTH0RlZE <br /> awbom0my) <br /> TO RELEASE ANY AND ALL ANALYTICAL O TION SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH <br /> DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT <br /> TIME TT IS PROVIDED TO ME OR MY REPRESENTATIVE <br /> 7 <br /> BUS S N . <br /> fApplicable) <br /> OWNERJOPERATOR <br /> (Please Plifil (771tle) <br /> 10"7 <br /> sr/ Brat®r Si e) (mate) <br /> ADDRESS: <br /> (MailingA&lress) <br /> (City) (State) (Lip Coale) <br /> ONE: <br /> EH 23 OW46 Z1124/02) <br /> 6 <br />