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NOT AP <br /> PLICABL <br /> ENVIRONMENTAL E LT T` _. - N , <br /> SAN JOAUIN COUNTY YA oo <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 1- ,rod t1 2 <br /> AUTHORIZATION TO RELEASE Lp 17. <br /> SLL � _01 <br /> *ANALYTICAL RESULTS <br /> ENVjpC)',jiVj�:i`!t AL <br /> * GEOTECHNICAL DATA <br /> * ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> I,THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY LOCATED AT <br /> 10858 TRINITY PARKWAY STOCKTON <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH <br /> DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED TO ME OR MY <br /> REPRESENTATIVE. <br /> BUSINESS NAME: CHEVRON SS#307709 <br /> (If Applicable) <br /> OWNER: CHEVRON PRODUCTS CO. <br /> (Please Print) (Title) <br /> (Owner Signature) (Date) <br /> ADDRESS: 6001 BOLLINGER CANYON ROAD <br /> (Alailing Address) <br /> SAN RAMON CA 94583 <br /> (City) (State) (Zip Code) <br /> PHONE:(925 )842.1000 <br /> EH 23 046 (Revised 07/17/14) <br /> 6 <br />