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J !4f-t N I O A Q U I �� EhVircxttn�(:nt,�l P"ia r(iPt I)C.C«ri;ztCri! <br /> Ji1. : l <br /> AUTHORIZATION TO RELEASE <br /> "ANALYTICAL RESULTS <br /> 'GEOTECHNICAL DATA <br /> 'ENVIRONMENTAL/SITE ASSESSMENT INFORMATION <br /> 1,THE UNDERSIGNED OWNER ANDiOR OPERATOR OF THIi PROPERTY AND/OR FACIIJ I'Y LOC.ATLD AT <br /> 2908 West Benjamin Holt Dr. Stockton <br /> (Sheet Address) (00) <br /> HEREBY AUTHORIZE <br /> Advanced Geo <br /> (Laboratory) r„ <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 1'0 ME OR <br /> MY REPRESENTATIVE. <br /> BUSINESS NAME: <br /> Wight Holdings Inc. <br /> (IfAppticable) <br /> OWNER- Lawernce Wight Owner <br /> (Please A'int) (Title) <br /> G - (Owner Signature) (Date) <br /> ADDRESS• <br /> 2908 W. tienjam Holt Dr. <br /> (Mailing Address) — <br /> Stockton CA 95205 <br /> (City) (State) (Zip Cade) <br /> PHONE: <br /> (209 )993-7825 <br /> j;. <br /> sE:5 <br /> 6 of 6 ' b( <br /> . 1 <br />