Laserfiche WebLink
SANJ 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 THE PROPERTY AND/OR FACILITY LOCATED AT <br /> 2849 E Myrtle Street Stockto <br /> (Street Ad r� (City) <br /> HEREBY AUTHORIZE <br /> Alpha Scientific Corporation, 16760 Gridley Road,Cerritos,CA 90703 <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONMENTAL <br /> HEALTH DEPARTMENT AS SOON AS 1T IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED TO ME OR <br /> MY REPRESENTATIVE. <br /> BUSINESS NAME: <br /> San Joquin Regional Transit District(RTD) <br /> (If Applicable) --- <br /> Owner: Darla Smith for RTD Superintendent <br /> or6&a� <br /> (Owner Signature) tnutel <br /> ADDRESS: <br /> P O Box 201010 (Mailing Address) <br /> Stocton,CA 95201 <br /> (City) (State) (Zip Code) <br /> 209 467-6671 PHONE: <br /> 6of6 <br />