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REQUEST FOR PRIORITY REVIEW.- <br /> TO: <br /> EVIEW:TO: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 SAN JOA QUIN ST. <br /> P.O. Box 2009 <br /> Stockton, CA 95201 <br /> FROM: bw-A A& SERNW'E <br /> (company name) <br /> RE: Iii c)S PJ , NwmpioA y A UE <br /> (facility address) <br /> i< r � <br /> 04 4,52,05 <br /> I(We) request that our project be assigned to available San Joaquin County Public Health <br /> Services, Environmental Health Division: (PHS-EHD) staff as a priority review. <br /> I(We) understand that the review fee,for this priority request is conducted during offer hours <br /> at an overtime rate of time and one-half of$53.00 (LS x $53.00). <br /> Furthermore, I(We) understand that the P1IS-E17D will bill the responsible party(ies) <br /> identified on the "Site Mitigation Acla:owlerlgenent/Request for Services Form"for services <br /> rendered. <br /> Signature and Title Date <br /> 41�/ A&/kitty -1¢ <br /> KUJ�r MEVgAr2rAl <br /> Page 17 <br />