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SAN JOAQUIN COUNTY <br />304 East Weber Avenue, Third Floor, St n, California 95202 <br />Telephone: (209) 3420 Fax: (209) 3433 <br />TNIS PERW EMRES 90 DAYS FROM THE APPROVAL OATS MCATE PERMfr TYPE BELOW <br />UTANK RETROFIT UPIPING REPMURETROFTT Lk= REPAfR/RE"MT <br />/ <br />inT <br />. ...,. F <br />+ Ir <br />•iceMIAMI- <br />1itl .1 <br />..,. .., • <br />1. ' �1��,'Ti% <br />1 rr �1� s <br />.. ,. .<, <br />1 <br />See-Aftachmnt With Conditions) <br />:.. <br />Plan Reviewers _ .,���/ <br />t.. ,_ <br />..�.,..•..... <br />♦ ♦:. - •.� •. ♦ ..ice ...�. [ �. 4\^: �• . •: �.:f.. •.. ..�..»..i.. . • : :_' •. _•�•• w _ >� •. <br />BlWNO RMATION: ' ' <br />indicate the responsible party to be billed for additional EHD staff fie expended beyond permit payment coverage per tank If <br />the party designated below is different than the permit applicant, e.g. property owner; the .party must acbwwliedge this <br />respo illy for the biimcj by sgnabire and date below. <br />A ►� i �'l i I i��� »TLE(DFFj ftnO PHONE <br />Ari,Riz��� <br />EH23DO38 (revised 8MM) <br />1 <br />