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SA N J 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 /> I, THE UNDERSIGNED OWNER AND/OR OPERATOR OF THE PROPERTY AND/OR FACILITY LOCATED AT <br /> 2808 Country Club Blvd Stockton <br /> (StreetAddress) (City) <br /> HEREBY AUTHORIZE <br /> Sun Star Laboratories , Inc . <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 /> Safeway , Inc . <br /> (If Applicable) Environmental Compliance <br /> OWNER : <br /> Keith B . Powers Manager <br /> (Please Print) (Title) <br /> 8/7/2023 <br /> (Owner Signature) (Date) <br /> ADDRESS : <br /> 5918 Stoneridge Mall Rd <br /> (Mailing Address) <br /> Pleasanton , CA 94588 <br /> (City) (State) (Zip Code) <br /> PHONE: <br /> 510 -246-0358 <br /> 6 of 6 <br />