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10/17/2000 09. 010 2094583433 <br /> FIFTH FLOOR PAGE 09 <br /> SAN JOAQUIN COUNTY PU8L.IC HF—ALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> (209)468-3420 <br /> AUTHORIZATION TO RELEASE <br /> * ANALYTICAL RESULTS <br /> * GEOTECHNICAL DATA <br /> ENVIRpNIvIENTAUBITE ASSESSMENT INFORMATION <br /> I, THE UNDERSIGNED OWNER. ANI3i0It OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 6425 PACIFIC AVENUE, STOCKTON, CAI <br /> (SFreer Address) (Cfry) <br /> HEREBY AUTRORIZE <br /> TO RELEASE ANY AND ALL A NA Z.YT'CAL INFORMATION TO SAN JOAQUIN COUNTY PUBLIC <br /> HEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION AS SOON AS IT IS AVAILABLE AND AT THE SAME <br /> TMM rr IS PROVIDED TO ME OR MY RWRESSNTATIvE_ <br /> • BUSINESS NAME <br /> (Zf Applrcabk) <br /> OWNIER/OPERATOR. OWNER <br /> (Please PWnr) ClfiJe) <br /> Pwner/Operator Signature) (Dare} <br /> ADDRESS <br /> (Mailing Address) <br /> DANVILLE CA 914526 <br /> (City) (Stats) Op- Cade) <br /> PHONE (__U 2 5 )� <br /> 830 <br /> EH 23 046 02vssed 08113199) Page 9 <br />