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REQUEST FOR PRIORPIY REVIEW: <br /> TO: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENMONMENTAL HEALTH DIVISION <br /> 445 SAN JOA QUIN ST. <br /> P.O. Box 2009 <br /> Stockton, CA 95201 <br /> FROM: ATG 4sscc�'�s <br /> (company name) <br /> RE: `�, s4Y. Fwd Seo lv�b�s� .a1 {���c 4� v�� ly/ <br /> C1 I�LH �'V <br /> (facility address) <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 off hours at <br /> an overtime rate of time and one-half of$78.00 (1.5 x$78.00). <br /> Furthermore, I(We) understand that the PHS-EHD will bill the responsible party(ies) <br /> identified on the "Masterfile Record Information Form and General Program File Farm"for <br /> services rendered. <br /> Siature and Title Date <br /> Q �� 1sE Lacs <br /> Page 16 <br />