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08'(14'99 "ED 10:20 FAX 51U 663 4141 GEOfATRIY OAKLAND 002 <br /> REQUEST FOR PRIORI7T REnETV• <br /> SAN JOAQUIN COUNTY <br /> T0- ENVIRONMENTAL HEALTH DIVISION <br /> Karen Furst, M.D., M.P.H., Health Officer j <br /> 304 East Weber Avenue, Third Floor - Stockton, CA 95202 <br /> 209/468-3420 1 <br /> r <br /> FROM. <br /> (CO+r[Ppny a'me) V <br /> PIE: -);t- L'- 4:-.doo V 6 )t ,rrrL <br /> (facility addrrss) <br /> 1(We) request that our project be assigned to available San Joaquin County Public Health <br /> Services, Environmental Health Division (PHS-EUD) staff as a priority review. <br /> 1(We) understand that the review fee fog this prior'eY rrques-t is carulacted during Iff hours at <br /> an overtime rate of tame and one-half of 573.00 (1.5 .r S78.00)- <br /> Furthermore, 1(We) understand that the PHS-EHD will bill the responsible party(ies) <br /> idenlifsed on the "Mastirf2le Record Cilformation Form and General Program File ,Form"for <br /> services rendered. <br /> Signature and Pude <br /> Date <br /> Page 16 <br /> d W0d.:J hV4F l l 666 l-EO-R <br />