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SA N Q °J OAQ U I N Environmental Health Department <br /> — CCUNTY- <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 LOCATED AT <br /> 2849 E Myrtle Street Stockton <br /> ( Street Address) (City) <br /> HEREBY AUTHORIZE <br /> 14up Srxi aA37 ;/. a(i; P , Bagley Enterptim i6j& o G tkn "y izn , C� t� .-rraS , Cry9ejc3 <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY ENVIRONMENTAL <br /> HEALTH DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE SAME TIME IT IS PROVIDED TO ME OR <br /> MY REPRESENTATIVE . <br /> BUSINESS NAME : <br /> San Joquin Regional Transit District (RTD) <br /> (IfApplicable) <br /> Owner: Darla Smith for RTD Superintendent <br /> (Title) <br /> ft %sner Signature) (Data) <br /> ADDRESS : <br /> P O Box 201010 (Mailing Address) <br /> Stocton, CA 95201 <br /> (City) (State) (Zip Code) <br /> { 209 467-667 ] PHONE: <br /> T\ D <br /> fib <br /> 2D1 � <br /> j_tJE1�;1AJL , 11 ALTR <br /> � p (IRv <br /> 6 of 6 <br />