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J I I Environmental Health Department <br /> COUNTY _ <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 /> (Street Address) (City) <br /> HEREBY AUTHORIZE <br /> (Laboratory) <br /> TO RELEASE ANY AND ALL ANALYTICAL INFORMATION TO SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT AS SOON AS IT IS AVAILABLE AND AT THE <br /> SAME TIME IT IS PROVIDED TO ME OR MY REPRESENTATIVE . <br /> BUSINESS NAME : 7 - Eleven #41342 <br /> (If Applicable) <br /> OWNER/OPERATOR : Mark A . Tekin Manager , TA Charter Way , LLC <br /> (Please Print) (Title) <br /> (Owner/Operator Signature) (Date) <br /> ADDRESS : 2600 Dallas Parkway , Suite 370 <br /> (Mailing Address) <br /> Frisco TX 75034 <br /> (City) (State) (Zip Code) <br /> PHONE : ( 469 458 - 0485 <br /> 8of10 <br />