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Michael J. Infurna Jr. <br /> Senior REHS San JoaquinCounty <br /> Site Mitigation Unit IV / LOP Public <br /> Fifth Floor ' Health <br /> 0, E. Weber St. 3rd Fir. <br /> (209) 468-3454 <br /> fax: (209) 468-3433 Stockton, CA., 95202 <br /> Fax <br /> 3•AR <br /> From: MICHAEL INFURNA, REHS <br /> To: �� Fax#: 353 - 6 3 <br /> Pages: Phone: <br /> Date: 7-1-j 9 Re: PAPERWORK FOR DRILLING AT NEW SITE <br /> ❑ Urgent For Review ❑ Please Reply <br /> 0 Comments: IN ORDER TO ISSUE A BORING PERMIT FOR THE WORK YOU ARE PROPOSING,THE <br /> FOLLOWING PAPERS WILL NEED TO BE COMPLETED,SIGNED,AND RETURNED TO PHS-EHD FOR <br /> REVIEW AND APPROVAL: <br /> 1. A WORK PLAN,COMPLETE WITH THE PHASE 1 INFORMATION(ie,above ground usage&history), <br /> 2. THE"UNIT IV-MFR"FORM PLUS A SEPARATE CHECK FOR$234 MADE OUT TO"PHS-EHD", <br /> 3. A BORING PERMIT APPLICATION FOR EACH PARCEL AND MATCHING$89 CHECK EACH, <br /> 4. ANY CITY OR COUNTY ENCROACHMENT PERMITS OR PRIVATE PROPERTY ACCESS <br /> AGGREEMENTS. DO NOT SCHEDULE A DRILLING DATE UNTIL A PHS-EHD STAFF MEMBER <br /> ADVISES YOU THAT THE PERMIT(S)HAVE BEEN ISSUED. <br /> 5. SITES UNDER OTHER AGENCY(CVRWQCB or DTSC)OVERSIGHT MUST HAVE THE WORKPLAN <br /> AND THE APPROVAL TO START ON FILE WITH PHS-EHD PRIOR TO ISSUANCE OF BORING <br /> PERMITS. THE$234 FEE MAY BE WAIVED IF THE BILLING PARTY ON FILE WITH PHS-EHD IS STILL <br /> THE PARTY TO RECEIVE THE BILLING. <br /> STATEMENT OF CONRDENT/AUTY.• The information in this facsimile is legally privileged and confidential information <br /> intended only for the use of the addressee listed on this cover sheet if the reader of this message is not the intended <br /> recipient,or the employee or agent responsible to deliver it to the intended recipient;you are hereby notified that any <br /> dissemination,distribution or copying of this telecopy is strictly prohibited. if you have received this facsimile in error, <br /> Please immediately notify us by telephone at the number listed on this cover sheet and retum the original message to <br /> us at the above address via United States postal Service. We will reimburse your costs in notifying us and returning the <br /> message to us. Thank You <br />