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I <br /> REQUEST FOR PRIORITY REVIEW <br /> TO: SAN JOAQUIN COUNTY PUBLIC IIEALTII SERVICES <br /> EA RONMENTAL FIEALTT;r DIVISION <br /> 445 SAN joxQU1N ST <br /> P.O. Box 2009 <br /> Stockton, CA 95201 <br /> FROM: <br /> (company name) <br /> RE. <br /> (facility address) <br /> I(]-Ye) request that our Project he assigned to available San .Toaquin County Public Health ' <br /> Services, Environmental Health Division (PHS-EHD) staff as a.priority review. r <br /> I(M) understand that the review fee for this Priority request is conducted during oBIce ]tours I <br /> at an overtime rale of time and one-Half of$53.00 (1.5 x $53.00). <br /> Furthermore, I(TYc) understand that the PETS-E D will bill the responsible party(ies) <br /> identified on the "Site Mitigation Acknoi�{Iedgemertt/Regttest for Services Forin"for services <br /> rendered. <br /> 4 <br /> { <br /> I <br /> Signature and Title Date <br /> i <br /> I <br /> F <br /> I <br /> i <br /> Page 17 <br /> I <br />