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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 3 East Eleventh Street Tracy, CA <br />(Street Address) (City) <br />HEREBY <br />AUTHORIZE Precision Enviro-Tech, Stockton, California <br />(Laboratory) <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 SAME <br />TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br />BUSINESS NAME: <br />OWNER/OPERATOR: <br />ADDRESS: <br />Levand - Bright Property <br />PHONE:( 661 <br />EH 23 046 (Revised 8/1/11) <br />(If Applicable) <br />Louis Levand Trust, Et. al <br />(Please Print) <br />(Owner/Operator Signature) <br />24692 Sand Wedge Lane <br />(Mailing Address) <br />Valencia <br />(City) <br />� 904-2133 <br />8 <br />Paula Levand. Trustee <br />(Title) <br />(Date) <br />CA 91355 <br />(State) (Zip Code) <br />