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SAN JOAQUIN COUNTY <br />304 East Weber Avenue, Third Floor, Stockton, California 95202 <br />Telephone: (209) 468-3420 Fu: (209) 468-3433 <br />7M PERMIT EXPIRES 90 DAYS FROM THE APPROVAL DATE INDICATE PERMIT TYPE BELOW <br />UTANK RETROFIT UPIPING REPAIURETROFIT ULDC REPARfiMROFIT <br />BIWNG INFORMATION: <br />indicate the responsible party to be billed for additional END staff tone expended beyond permit payment coverage per tank If <br />the party designated below is different than the permit applimra, e.g. property owner, the party must admowledge this <br />msponsbi r the billing by signature and date below. <br />NAME TITLE <br />(/I/Yv�. .� ,� � (� + <br />EH23OD38 (revised 8MM) <br />1 <br />fr'Rxa`Y <br />••. `�. I Lt a <br />� <br />MUM <br />0 <br />N <br />rim <br />r <br />r <br />BIWNG INFORMATION: <br />indicate the responsible party to be billed for additional END staff tone expended beyond permit payment coverage per tank If <br />the party designated below is different than the permit applimra, e.g. property owner, the party must admowledge this <br />msponsbi r the billing by signature and date below. <br />NAME TITLE <br />(/I/Yv�. .� ,� � (� + <br />EH23OD38 (revised 8MM) <br />1 <br />