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07-22-1994 01:29PM FROM <br /> SITE MITIGATION PROGRAM <br /> $ILLING AETTim OF ACXNOWLEDGM4MT2 <br /> TO: SAN JOAQUINCOUNTY PU$LYC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION (PHS-EHD) <br /> 445 N. SAN JOAQUIN ST. <br /> P. O.. BOX 2009 <br /> STOCKTON, CA 952Oz <br /> FROM: <br /> (property owner name) <br /> (owner mailing address) <br /> (City, state, ZIP) <br /> RE: (site address) <br /> I(We) declare that the assessment activity being performed at the <br /> above referenced site is being conducted with my(our) knowledge and <br /> approval Furthermore, I(we) acknowledge that payment of PHS-EHO <br /> charges will become my(our) responsibility in the event said <br /> charges re not paid by the client and/or oporator identified on <br /> the attached "General Program File.,, <br /> signatu a and title (phone number) <br /> (date) <br /> LC\BILAC .FRM <br /> TOTAL P.01 <br />