Laserfiche WebLink
SITE MITIGATION PROGRAM <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. O. BOX 2009 <br /> STO(CKTON, CA 95201 <br /> FROM: J In15 CWLk .e 0ah1 C krljj <br /> Q{ <br /> (property owner ,-name) <br /> 374 �rncelvi hlry <br /> (owner maiming address) <br /> (cit , state, ZIP) <br /> w s SLq P P, C'e v/ ✓ <br /> RE: i 7© o ijrr7 VnV1✓f/- C_ a-k,.f. <br /> (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 b ome ur) espon ility in the event said <br /> charges a ai th ient /or operator identified on <br /> the G ne <br /> (signature an i ) (phone number) <br /> (date) <br /> LC\BILACKN.FRM <br />