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SA N J 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 /> 1323 W. Charter Way , Stockton , CA 95206 <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE <br /> BC Laboratory <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 : Associated Tractor Service , Inc . <br /> (If Applicable) <br /> OWNER/OPERATOR: Margo Bentz Ivers Owner <br /> (Please Print) (Title) Crl� S I <br /> (Owner/Operator Signature) (Date) <br /> ADDRESS : 4750 Lagorio Rd . <br /> (Mailing Address) <br /> Stockton , CA 95215- 1811 <br /> (City) (State) (Zip Code) <br /> PHONE : ( 209 483 - 7285 <br /> 8of10 <br />