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SANJ O A Q U I N Environmental Health Department <br /> COUNTY <br /> AUTHORIZATION TO RELEASE <br /> * ANALYTICAL RESULTS <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 /> 1501 N JACK TONE RD . RIPON, CA <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE <br /> ALPHA ANALYTICAL INC, (916) 366 -9089 9891 Horn Road Suite C Sacramento, CA 95827 <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 <br /> SAME TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE . <br /> BUSINESS NAME : PILOT TRAVEL CENTERS ., LLC <br /> (If Applicable) <br /> OWNER/OPERATOR: <br /> (Please Print) (Title) <br /> wne O r to igi at (Date) <br /> ADDRESS : 5508 LONAS DR. <br /> (Mailing Address) <br /> KNOXVILLE TN 37909 <br /> (City) (State) (Zip Code) <br /> PHONE: ( 877 ) 866 - 7378 <br /> 8of10 <br />