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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 />' <br />GEOTECHNICAL DATA <br />• <br />ENVIRONMENTAL'SITE ASSESSMENT INFORMATION <br />I. THE UNDERSIGNED OWNER AND OR OPERATOR OF THE PROPERTY ANWOR FACILITY <br />LOCATED AT 3 East Eleventh Street Tracy. CA <br />Sir -ret Address) (Gill! <br />HEREBY <br />AUTHORIZE Precision Enviro-Tech, Stockton, California <br />(Laburruur�y <br />TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY <br />ENVIRONNIENTAL HEALTH DEPARTP4ENT AS SOON AS IT IS AVAILABLE AND AT THE SAME <br />TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br />BUSINESS NAME: <br />Levand - Bright Property <br />(!t AppLcalrleJ <br />Ot1rNERUOPE-RATOR. <br />Louis Levand Trust. Et_ al. <br />Paula Levand. Trustee <br />(Pico 'e Fr u: f! �j'�� <br />(Till' <br />r0»nci•,'Operacor arl;,ruuu•r� <br />Ware) <br />ADDRESS: <br />24692 Sand Wedge Lane <br />f.tlurbnp_ Addrr�.%) <br />Valencia CA <br />91355 <br />t0 fl) (Scare) <br />tZip Code! <br />PHONE:( <br />661 )904-2133 <br />111-1.23(J46 (Revised 81 1111) is <br />SAN JOAQUIN COON-CY ENY11RONYIEN TAL HEALTH DEPARTMENT <br />SERVICE REQUEST <br />Type of Business or PropertyI FACILITY IDR I SERVICE REQUEST 4 <br />Vacant <br />O'.1'NER I OPERATOR <br />Louis Levand Trust, Et. al., Cc Ms. Paula L --,-and Aommla <br />