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Michael J. Infurna Jr. <br /> Senior REHS San JoaquinPublic <br /> Site Mitigation Unit IV/ LOP Health Services, <br /> Fifth FloorEnvironmental Health <br /> (209) 468-3454 � , Weber <br /> fax: (209) 468-3433 A 0 <br /> rd <br /> Fax5 <br /> From: MICHAEL INFURNA, REHS <br /> To: TODD LOAR, GEOMATRIX Fax#:510-663-4141 <br /> Pages: 4 Phone: <br /> Date: 2-25-00 Re: PAPERWORK FOR DRILLING AT NEW SITE <br /> •Comments: IN ORDER TO ISSUE THE BORING PERMIT(S)FOR THE WORK YOU ARE <br /> PROPOSING,THE FOLLOWING PAPERS WILL NEED TO BE COMPLETED,SIGNED,AND <br /> RETURNED TO PHS-EHD FOR REVIEW AND APPROVAL: <br /> 1. A WORK PLAN,COMPLETE WITH THE PHASE 1 INFORMATION(i.e.,above ground usage& <br /> 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 and SIGNED"LICENSED CONTRACTOR DECLARATION" <br /> FOR EACH PARCEL AND MATCHING$89 CHECK EACH, <br /> 4. ANY CITY OR COUNTY ENCROACHMENT PERMITS OR PRIVATE PROPERTY ACCESS <br /> AGGREEMENTS. A SEPARATE CHECK AND SEPARATE BORING PERMIT APPLICATION IS <br /> NEEDED FOR EACH CITY OR COUNTY RIGHT OF WAY ENCROACHMENT PERMIT ISSUED(ie, <br /> if the City of Tracy issues three encroachment permits,you need to submit 3 separate checks <br /> and applications). In this case, RailRoad access agreements for this work also need to be <br /> submitted to EHD. DO NOT SCHEDULE A DRILLING DATE UNTIL A PHS-EHD STAFF MEMBER <br /> ADVISES YOU THAT THE PERMIT(S)HAVE BEEN ISSUED. <br /> STATEMENT OF CONROENTIALITY., The Infomratlon in this facsimile Is legally prMleged and confidential intonnaflon Intended only Por the—e of the addressee listed on this coversheet IF the <br /> readerofthis message is not the Intended mclplan4"the employee oragent responsible to deliverit to the Intended reclpierut you are hereby notified that any dissemination,dishibutlon or copying <br /> of this telecopy is strictly prohibited.If you have received this facsimile in error,please immediately notify us by telephone at the numberllsted on this coversheet and return the Original message to <br /> us at the above address We United States Postal Service.We wilireimburse yourcosts in notifying us and retuming the message to us.Thank You. <br />