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• F FY 5 � �_ to�7,��['1 � �3 C . <br /> z MAY <br /> E \00NIVIEN <br /> TAS.HEALTH <br /> REQUEST FOR PRIORITY RE VIEW: PERMIT/SERVICES <br /> TO: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL IIEALIII DIVISION <br /> 445 SAN JOAQ UIN ST. <br /> P.O. Box 2009 <br /> Stockton, CA 95201 <br /> 1 c nmol4�/ <br /> (company name) r <br /> G �-L'ne t2 ion d -r- I G. 2o�f►r�� <br /> RE: ray <br /> facility address) <br /> I(We) request that our project be assigned to available I Sync Joaquin County Public Health <br /> Services, Environmental health Division (PHS-EHD) staff as a priority review. <br /> I(We) understand that the review fee for this priority request is conducted during office hours <br /> at an overtime rate of time and one-half of$53.00 (1.5 x $53.00). <br /> Furthermore, I(We) understand that the PHS-EIID will;bill the responsible party(ies) <br /> identified on the "Site Mitigation Acknmvledgement/Request for Services Form"for services <br /> rendered. <br /> e <br />- , Signature and Title j P� I � -�f Mir; Date S � <br /> t. <br /> Page 17 <br /> l.^ ._. .a .. .. - :F .:—ir+r -t .-e -!� _ .- v.._ ._ .. '.'P . 1•A t .. .- si,"a! <br />