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BCE#10050 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Telephone: (209)468-3420 Fax: (209)468-3433 <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 <br /> LOCATED AT <br /> 3250 West Grantline Road Tracy CA <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE <br /> . (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH <br /> DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE SAME <br /> TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: Costco Wholesale <br /> (IjApplicable) <br /> OWNER: <br /> Dennis Rock Environmental Compliance Manager <br /> (Please (Title) <br /> �i ` tVgi :yy c6 <br /> - <br /> (Owner Signature) (Date) <br /> ADDRESS: 999 Lake Drive <br /> (Mailing Address) <br /> Issaquah WA 98027 <br /> (City) (State) (Zip Code) <br /> PHONE:( 425 1313-8700 <br /> EH 23 046 (Revised 02/20/09) <br /> 5 <br /> 10050.004-pdf.doc <br />