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Lori Duncan [EH] <br /> From: Lori Duncan [EH] <br /> Sent: Wednesday, May 06, 2009 4:27 PM <br /> To: 'nvolpi@sbcglobal.net' <br /> Subject: Permit forms <br /> Attachments: Scanned_.pdf <br /> Scanned_.pdf(314 <br /> KB) <br /> Hi Nancee, <br /> Here are the different forms we need for the permit. I checked our file for your site and <br /> the Master File Record form (MFR) that we currently have lists AGE as the billing party, <br /> so we will need a new MFR for me to be able to process the permit. It is the first form <br /> in the attachment. You do not need to fill it out in great detail, no SSN's or driver <br /> licenses for example, just the basic information to identify the site and to be able to <br /> get in touch with you, and it must be signed at the bottom. <br /> The next two pages are the drilling permit. The driller should sign the permit, and they <br /> must fill out the last page called Licensed Contractors Declaration which verifies that <br /> they have the proper license and insurance. <br /> Please call or write if this is not clear or if you have any further questions ! <br /> Lori <br /> Lori Duncan, Senior REHS <br /> San Joaquin County <br /> Environmental Health Department <br /> lduncan@sjcehd.com <br /> (209) 468-0337 phone <br /> (209) 468-3433 fax <br /> 1 <br />