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REQUEST FOR PRIORITY REVIEW: <br /> TO: SAN JO,4QUIN COUNTY PUBLIC HEALTH SERVICES <br /> EAWRONMENTAL HEALTH DIVISION <br /> 445 SAN JOAQUIN ST <br /> P.O. Box 2009 <br /> Stockton, CA 95201 <br /> Q � /4 <br /> FROM: J e 0 <br /> (company name) <br /> i P <br /> c e )z <br /> facility address�f ,�_(} -f� ,A �4 c.. <br /> f Ce <br /> I <br /> I(We) request that our project he assigned to available San Joaquin County Public Health <br /> Services, Environmental Health Division (PHS-EHD) staff as a priority review. <br /> I(We) understand that the review fee for this priority request is conducted during offas hours <br /> at an overtime rate of time and one-half of$53.00 (1.5 x $53.00). <br /> Furthermore, I(M) understand that the PHS-EI- will bill the responsible party(ies) <br /> identified on the "Site Mitigation Ackno►vledgerneritlRegtrest for Services Form"for services <br /> rendered. <br /> I <br /> Signature and Title �� Date124,10 <br /> I <br /> Page 17 <br />