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N/A <br /> BCE#13455 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Telephone: (209)468-3420 Fax: (209) 468-3433 <br /> ` AUTHORIZATION TO RELEASE <br /> N /A <br /> *ANALYTICAL RESULTS <br /> NO PIPING REMOVAL *GEOTECHNICAL DATA <br /> * NVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> 1,THE UNDERSIGNED OWNER AND/ R OPERATOR OF THE PROPERTY AND/OR FACILITY <br /> LOCATED AT 1711 E. Yose ite Manteca, California <br /> (Street Address) (City) <br /> HEREBY AUTHORIZE <br /> (L oratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMA ION TO SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH <br /> DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT HE SAME <br /> TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE. <br /> BUSINESS NAME: ARCO Fac! No. 6020 <br /> (If Applicable) <br /> OWNER/OPERATOR: <br /> /L... Hatch Area Mainten nce Manager <br /> (Please Print) (Title) <br /> (Owner/Operator Signature) (Date) <br /> ADDRESS: P. 0. Box 5 015 <br /> (Mailing Address) <br /> Buena Park CA 90622 <br /> (City) (State) (Zip Code) <br /> PHONE:( 510 ) 432-8397 <br /> EH 23 046 (Revised 8/3/07) <br /> 13455.002.pdf <br /> 4 <br /> I <br />