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. I <br /> SAN i,..,QUIN COUNTY PUBLIC HEALTH SERVk„o <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209) 468-3420 i <br /> i <br /> AUTHORIZATION TO RELEASE <br /> I <br /> I <br /> ANALYTICAL RESULTS <br /> • GEOTECIINICAL DATA <br /> i <br /> * ENVIRONMENTAUSITE ASSESSMENT INFORMATION <br /> I <br /> i <br /> i <br /> 1, 1 HE UNDERSIONED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT Panella Trucking, Inc. , 5000 E. Fremont St. , Stockton CA 95215 <br /> (Street Address) (01y) <br /> IIPREBY AU'IIIORIZE GeoAnalytical Laboratories <br /> (/obarnlar)) . <br /> IO RELEASE ANY AND ALL ANALY'T'ICAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> IIF.ALI11 SERVICES-ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME <br /> IIMF 11' IS PROVIDED TO ME OR MY REPRESENTATIVE. <br /> BUSINFSS NAME: Panella Trucking, Inc. <br /> (if Applicable) <br /> OWNFR/OPFRATOR: Bob Panella Owner <br /> (PleasePrint) (/JNe) <br /> -- neerr/'Op'erafo <br /> 1wr Signature) (bare) <br /> ADDRESS: 5000 E. Fremont St. <br /> (MalAng Address) <br /> Stockton, CA 95215 <br /> (City) (Stare) (Lip Cede) <br /> PIIONE: ( 209 ) 943-5000 <br /> 'H 21 MG (Revised 9/11/96) Page 9 <br />