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<br /> TATEp�a�,. :
<br /> "VLEll , the undersigned pr�►perty,sof,bustness�owrier, oeratoror authorized agent of-same,
<br /> arlct�awiec 5e that,all scte` rtdlor {rojec-0i XCtfic�'pUtl1"IC IIT.ALT111SERV1Cl±SitNVIRQNMCNTAL NCALTJI D .IVISiON,.hourly•.charges,
<br /> ''a"sSoc:iated.tiyitli-this ptnjlrct tir at tiviryewtll'bc b#lled_,to'ntc or lny;l il,sinen-as tden iicd nn ltis'Comi
<br /> ik lso -:i ltiat 1 have ycepared anis application end t:the work to:be e�otnied,wtirill be done in accordance`wnli all SAN 1onQu1N
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<br /> AI'I'Is`I�Ar`aT S SiGI+fATURE DATE
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<br /> " 'abstvc':.si1e`address`heceb autligrszo the c C;ksc:oi'anY atid;allrresuits; geo eclu teal data astd/or tnvtranmen[al/site assessment rw r
<br /> In#armatton o t(ie SA'N Jt)nptllt�Cbt1NTY PUtti ib»LA.T1[S�Itvi; GS D:NVIRDItM`CNTAL IIF�LTI1;DiV15lON as soon as it is available and
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