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S A N J O A Q U I N Environmental Health Department <br />--C U U N TY --- <br />I riumZJAI JAJIN <br />Y--- <br />THORIZATION TO RELEASE <br />* ANALYTICAL RESULTS <br />*ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br />I, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACII.,ITY LOCATED AT <br />1601 EAST HAZELTON AVENUE, STOCKTON CA 95205 <br />(Street Address) <br />MCCAMI'BELL ANALYTICAL INC. <br />(Laboratory) <br />(City) <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: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />(If Applicable) <br />OWNER/OPERATOR: Trina Edwards <br />(Please Print) <br />(Owner/Operator Signature) <br />ADDRESS: 1601 EAST HAZELTON AVENUE <br />(Mailing Address) <br />STOCKTON, CA <br />(City) <br />PHONE: ( 209 � 468-3411 <br />Project Manager <br />(Title) <br />(Date) <br />95205 <br />(State) (Zip Code) <br />