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N <br /> SAND A g U I N Environmental Health Department <br /> COUNTY- <br /> AUTHORIZATION TO RELEASE <br /> ANALYTICAL.RESULTS <br /> *GEOTECHNICAL DATA <br /> *ENVIRONr%4ENTALJSITE ASSESSMENT INFORMATION <br /> I,THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY LOCATED AT <br /> 7000 N Michael Canlis Blvd,French Camp <br /> (Streef Address) __...._.....__. (001) <br /> HEREBY AUTHORIZE <br /> Bagley Enterprises <br /> (Laboralmy) <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 Sheriffs Ops#I <br /> (IfApplieable) <br /> OWNER/OPERATOR: <br /> NER/OPERATOR: l{Imberty Harrls �] d <br /> (Please Priiil) <br /> ►vn r Signature) (Date) <br /> ADDRESS: 444 S Wilsan Wy Stockton CA <br /> (illailing Address) <br /> (Cil)) (State) (Zip Code) <br /> PHONE:469 <br /> 8of10 <br />