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Michael J. Infurna Jr. San Joaquin County <br /> Senior REHS Public Health Services, <br /> Site Mitigation Unit IV / LOP <br /> Environmental <br /> Fifth Floor <br /> 304 E. Weber St. 3rd Fir. <br /> (209) 468-3454 Stockton, CA., 95202 <br /> fax: (209) 468-3433 <br /> FaxFA- , 2ED) <br /> From: MICHAEL INFURNA, REHS <br /> To: LANGE JORSTAD, GEOMATRIX <br /> Fax #: (510) 663-4141 <br /> Pages: 3 <br /> Phone: <br /> Date: July 21, 1999 <br /> Re: NEW BORING PERMIT APPLICATION AND CONTRCTR FORM <br /> ❑ Urgent ❑ For Review ❑ Please Comment <br /> • Comments: HERE'S ANEW APPLICATION FORM FOR ALL FUTURE <br /> BORING WORK. THE "LICENSED CONTRACTOR DECLARATION" (LCD) <br /> NEEDS TO ACCOMPANY EVERY APPLICATION FORM AND MUST BE <br /> SIGNED BY THE C-57 CONTRACTOR ONLY. IF YOU SIGN THE APPLICATION, <br /> THE C-57 MUST FAX US AN "AUTHORIZATION TO SIGN" FOR YOU. I'LL <br /> NEED THE LCD NOW AND AUTH TO SIGN FOR THE PERMIT APPLICATION <br /> FOR THE SURLAND HOME MONITORING WELL. THE APPLIC IS OK AS YOU <br /> SENT IT. OK TO COPY THESE AS YOU NEED THEM AND KEEP THESE AS <br /> "MASTERS". QUESTIONS? CALL ME.. <br /> STATEMENT OF CONFIDENTIALITY. The information in this facsimile is legally privileged and confidential information intended <br /> only for the use of the addressee listed on this cover sheet. If the reader of this message is not the intended recipient, or the <br /> employee or agent responsible to deliver it to the intended recipient,you are hereby notified that any dissemination, distribution or <br /> copying of this telecopy is stnctly prohibited If you have received this facsimile in error.please immediately notify us by telephone <br /> at the number listed on this cover sheet and return the original message to us at the above address via United States Postal <br /> Service. We will reimburse your costs in notifying us and returning the message to us. Thank You <br />