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PUBLIC HEALTH SER'VTCES <br /> SAN JOAQUIN COUNTY s-+ <br /> ENVIRONMENTAL HEALTH DIVISION ; <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer4.. <br /> ��FOR <br /> 445 N. San Joaquin Street • P.O. Box 388 • Stockton, CA 95201-0388 <br /> (209) 468-3420 <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE <br /> CONTRACTOR/CONSULTANT LCY� j c— <br /> ADDRESS WHERE VIOLATION OCCURRED ] D r A <br /> SAN JOAQUIN COUNTY PHS/EHD REPRESENTATIVES <br /> I agree to fully comply with all the requirements of San Joaquin <br /> County Ordinance Code Chapter 9-1115 and notify San Joaquin County <br /> Public Health Services, Environmental Health Division (PHS/EHD) 48 <br /> hours in advance of performing any work covered under this law. <br /> I acknowledge that PHS/EHD is the enforcement agency for the <br /> California Underground Storage Tank Regulations and for the <br /> oversight of investigation and remediation of contamination <br /> resulting from an unauthorized release from an underground storage <br /> tank. Therefore, I agree to not perform any work at these sites <br /> without their approval. <br /> I understand that failure to comply with this agreement will result <br /> in further legal remedies. <br /> COMMENTS: <br /> (�ignature <br /> A Division of San Joaquin County Health Care Services <br />