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SAN :I a O A Q U I N Environmental Health Department <br /> - - COUNTY <br /> AUTHORIZATION TO RELEASE <br /> * ANALYTICAL RESULTS <br /> * GEOTECHNICAL DATA <br /> * ENVIRONMENTAL / SITE ASSESSMENT INFORMATION <br /> 1, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY LOCATED AT <br /> 1975 W Lowell Ave, Tracy CA 95376 <br /> Street Address Ct <br /> HEREBY AUTHORIZE <br /> Advanced Geo _ <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONMENTAL <br /> HEALTH DEPARTMENT AS SOON AS 1T IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED TO ME OR <br /> MY REPRESENTATIVE, <br /> BUSINESS NAME: <br /> (If Applicable) <br /> OWNER: ✓' Tracy Unified School Districte <br /> (Please Print) mile) <br /> (Owner Signature) 6" (Aate� <br /> ADDRESS : <br /> (Mailing Address) a5 37 <br /> I/ <br /> (City) (State) (Zip Code) <br /> PHONE : v" <br /> 6of6 <br />