Laserfiche WebLink
a <br /> L SITE MITIGATION PROGRAM <br /> I, <br /> BILLING LETTER OF ACKNOWLEDGEMENT: <br /> Yf <br /> ! 4 <br /> TO: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION (PHS 4HD) ; <br /> 445 N. SAN JOAQUIN ST. I <br /> P. 0. BOX 2009 <br /> STOCKTON, CA 95201 I <br /> FROM: + C- <br /> i� 1 <br /> (property owner name) i <br /> (owner mailing address) <br /> s <br /> Nati z <br /> (city, state, ZIP) j <br /> P <br /> I <br /> RE: l�� �it/�5 fQ <br /> s <br /> (site address) <br /> i <br /> 4 <br /> I (We) declare that the assessment activity being performed at the <br /> above referenced site is being conducted with ray(our) knowledge and <br /> approval. Furthermore, I(we) acknowledge that payment of PETS-EHD <br /> charges will become my(our) responsibility in , the event said <br /> charges are not paid by the client and/or operator identified on j <br /> the attached "Site Mitigation Acknowledgement%Request for Services ' <br /> Form. " <br /> 7 <br /> (signature and title) ] (pftone-number) r <br /> (date) 4 <br /> LC\BILACKN.FRM <br />