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Michael J. infurna Jr. <br /> Senior REHS San JoaquinCounty <br /> Site Mitigation Unit IV 1 LOP Public <br /> Fifth Floor Environmental <br /> Division....."PHS-EHO59 <br /> (209) 468-3454 304 E. Weber St. 3rdFir. <br /> fax: (209) 468-3433 Stockton, CA., 95202 <br /> Fax <br /> From: MICHAEL INFURNA, REHS <br /> To: FISCH ENVIRON-C-57 <br /> Fax #: 209-772-3571 <br /> Pages: 3 (includes cover sheet) <br /> Phone: <br /> Date: November 18, 1999 <br /> Re: BORING PERMIT APPLICATION, & BACK PAGE (LCD) <br /> • Comments: <br /> HERE ARE THE NEW FORMS WE ARE USING FOR BORING 1 WELLPERMITS. YOU SHOULD <br /> SAVE THESE AS MASTERS AND REPRODUCE THEM AS YOU NEED. IF THE CONSULTANT <br /> SIGNS THE APPLICATION, THE C-57 MUST FILL IN THE BOTTOM OF THE "LICENSED <br /> CONTRACTOR DECLARATION"(LCD). <br /> THE C-57 SHOULD CHECK ( ALL AREAS THAT ARE RELEVANT. ONLY THE C-57 CAN SIGN <br /> THE LCD OR THE "AUTHORIZATION TO SIGN" AREA. THE CONSULTANT OR THE C-57 <br /> CONTRACTOR CAN FAX THE SIGNED FORMS TO PHS-EHD. <br /> PLEASE COMPLETE ONE NOW FOR 330 KETTLEMAN LANE, LODI FOR "GROUND ZERO" for <br /> ONSITE WORK. I'LL COMPLETE THE TWO BLANKS AT TOP AFTER YOU FAX IT BACK TO <br /> ME.—THANKS <br /> STATEMENT OF CONFIDENTIALITY:The information in this facsimile is legally privileged and confidential information intended only for <br /> the use of the addressee listed on this cover sheet if the reader of this message is not the intended recipient or the employee or agent <br /> responsible to deliver it to the intended recipient you are hereby notified that any dissemination,distribution or copying of this telecopy is <br /> strictly prohibited. If you have received this facsimile in error,please notify us immediately by telephone at the number listed on this cover <br /> sheet and return the original message to us at the above address via United States Postal Service. We will reimburse your costs in <br /> notifying us and returning the message to us. Thank You. <br />