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REQUEST FOR PRIORITY REVIEW.- <br /> TO: SAN JOAQ UIN CO UNTY P UBLIC I3'EAL TII SERVI ES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 SAN JOAQ UIN ST. <br /> P.O. Box 2009 <br /> Stockton, CA 95201 <br /> FROM: <br /> (company name) <br /> I <br /> RE: C ma, -L rie (Ld (a -e Zos� vr� <br /> acility address) <br /> I(IYe) request that our project he assigned to available Says Joaquin County Public Health- <br /> Services, Environmental health Division (PSIS-EMD) staff as a Priority review. <br /> JF <br /> i <br /> I(iYe) understand that the review fee far this priority request is conducted during office hours I <br /> at an overtime rate of time and one-half of$53.00 (1.5 x $53.00), <br /> Furthermore, I(M) understand that'ihe PIIS-EIID will bill the responsible party(ies) ' <br /> identified on the "Site Miligation Acknowledgement/Request for Services Form"for services <br /> rendered. <br /> Signature and Title Date 5--13 1 <br /> 0�'a��r•g r►�r�>r <br /> Page 17 <br /> 4 <br />