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'..ai.Brtrcnt ua ik; xiiveiie:�i' i, <br /> ae Datef C'ecef�er 1, i' <br /> ily�i <br /> inaltie5 will be added after Notify itpe Environxental Nee <br /> Lie date a5 stlownI Division of any corrections ur <br /> charrge5 necessary. Permit will be <br /> days -10(1% of Base Fee imbed upcm receipt of payment- <br /> Return payment ailing with one copy <br /> at this 5tateruent to: <br /> Public Health Services, San loaqu.. <br /> County/Environmental Health <br /> P. u. Sox 20<i'3, Stockton, CA 952('' <br />