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SANAMIN <br />---COUNTY--- <br />Environmental Health Department <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 />20500 Holly Dr Tracy <br />(Street Address) (City) <br />HEREBY AUTHORIZE <br />Forensic Analytical and / or McCampbell Analytical Inc. <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: <br />OWNER/OPERATOR: <br />ADDRESS; <br />PHONE: <br />'Applicable) <br />Print) / (Title) <br />8of10 <br />