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07-22-1994 01:29PM FROM <br /> SITE MITIGATION PROGRAM <br /> BILLING ETTER OP ACKNOWLEDGEMENT: <br /> TO: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION (PHS-EHD) <br /> 445 N. SAN JOAQUIN ST. <br /> P. O.. BOX 2009 <br /> STOCKTON, Ci 95201 <br /> FROM: S r1�5 �%/9/'T �oocls �.�a�� � �"«„t Tr✓r:se< <br /> (property owner name) <br /> .owner mai ng a ress <br /> (city, s ate, ZIP) <br /> RE: - <br /> si a address) <br /> I(We) de lare that the assessment activity being performed at the <br /> above rel erenced site is being conducted with my(our) knowledge and <br /> approval Furthermore, I(we) acknowledge that payment of PHS-EHD <br /> charges will become my(our) responsibility in the event said <br /> charges iLre not paid by the client and/or opwrator identified on <br /> the atta hed "General :Program File. " <br /> Z4iq;r�w: <br /> a and titl (phone number) <br /> G <br /> (date) <br /> LC\BI.LAC .FRM <br /> TOTAL P.01 <br />