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i <br /> SITE MITIGATION PROGRAMS <br /> BILLING LETTER OF ACKNOWLEDGEMENT: <br /> TO: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION (PHS-EHD) <br /> 445 N. SAN JOAQUIN ST. <br /> P. 0. BOX 2009 <br /> STOCKTON, CA 95201 <br /> IW4et-6y Gooc-iNG TOuJE2 GOMOANy <br /> FROM: (property owner name) <br /> /SO Al. 5/1VGGA1R 4116- <br /> (owner mailing address) <br /> 5,0cicro,4 / C.4 9s206 <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-EHD <br /> charges will become my(our) responsibility in the event said <br /> charges are not paid by the client and/or operator identified on <br /> the attached "Site Mitigation Acknowledgement/Request for Services <br /> (signature and title 1\J/ (phone number) <br /> l 3 S <br /> datea <br /> ) <br /> LC\BILACKN.FRM <br />