Laserfiche WebLink
S A 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 TI£PROPERTY AND/OR FACILITY LOCATED AT <br /> 7000 N Michael Canlis Blvd,French Camp <br /> (Street Address) (00) <br /> Bagley Enterprises-ContractoHEREBY AUTHORIZE <br /> (L(rboru/oi j) <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 /> BUSINESS NAME: <br /> (If Applieable) <br /> OWNER: _San Joaquin County_ <br /> lease Prins) (TWe�)+--- <br /> (Owner Signature) (Date) <br /> ADDRESS: P O Box 1810 <br /> (d/ai/iug Address) <br /> Stockton CA 95201 _ <br /> (01)) (Stale) (Zip Code) <br /> PHONE: <br /> (__209__)_953.75008__ <br /> sots <br />