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SAN 10 A Q U IN 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 /> 1810 E Hazelton Ave, Stockton, CA <br /> (Street Address) (City) <br /> HER <br /> BY AUTHO IZE <br /> Bagley Enterprises/Advanced Geo/McCampbe t Analytical Inc <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONMENTAL <br /> HEALTH DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED TO ME OR <br /> MY REPRESENTATIVE. <br /> San Joaquin County Dept ouulic Works <br /> (1f Applicable) <br /> OWNER: Fleet Services KimbedyHarris Man agmen tAnalyst II <br /> (Please Print) (Title) <br /> December 13, 2022 <br /> r / (Owner Signature) (Date) <br /> �J 444 S Wilson Wy ADDRESS : <br /> (Mailing Address) <br /> Stockton CA +5205 <br /> (City) (State) (Zip Code) <br /> 209 953 -7508 PHONE: <br /> 6of6 <br />