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To: Page 2 of 2 2018-01-15 21:57:10 (GMT) 19162440197 From: Dan Ordoins <br />SAN JOAQUIN VALLEY UNIMD. AIR mt,wriON COMM DISTPOCT <br />COMPLIANCE QUESTIONNAIRE <br />48001 NTFRPKJ'-;E Wky-,k <br />.(249) 557-6400 ak FAX (209) -1,574475 - ;to <br />ATTENTION- FILE/ PERMIT NUMBER <br />tO BE FILLED OUT BY APPI .,ICA'NT:FOR NEW DFVE1-,OPMFNTS OF, PROJECTS INVOLVING <br />DENTOUTION ANPIOR. REN( V*TION AND SUBMITTED TO THE S3VA?CD OFFICE ABOVE <br />....-JECT NAME: !nos TODAY'S PATE: I D <br />BUSINESSIPRO <br />PROJE= SITE ADURESS: <br />Ga 11 $I C- 11 CITY, <br />CONTACT NAME.--- L-)—Qnz3F <br />PHONE4, <br />DEVELOPER: PHONE#: FAV, <br />PR0JLC'r.QWR1PT1ON- XmAju X"I cax,,LE ?-c kLw,<Cm4 <br />YES HAP (Rule 4#D2-Bixildin2l)cmolition/Renovalio <br />W111 =I, load-bewing structure be.rq4pvpV,.. <br />................... <br />2, Anmnt, of existing building mawrial to be divurbodduring 11is project <br />GmAw ft an 260 litucar feet ofinsulated or nqD-metallic pipe or simillar mataial-.... ........... <br />Geweriiiao160square.feetofinbedororexiaiorwatt, llwin& c4ling, roofuz& ..YF -S[ KO <br />Indirect S�aure.:RcvimtRule9'itQ'I (9,4ks available atwww .'rall9ya;tr.0MJ <br />1'ypqpf Space Ta Be CormtMed (check 91 that apply.).,pl"Commercial" I I Residentiat Eduextional I j Light Industrial <br />Wice f I (2awtrnmeng Rteresfienall Qth;rj1LWdes'ffis.,d <br />jfe-XVyjjs&ME1ial t j MedlicalOfflor I Gene�*Q <br />4. <br />Square Fwitagp of buildings) L4 be QLp%Vcw, a ft: I T"Ant Improvoracat (Mto Existing S pace owy <br />-Ry*302:11-�Dwt Control at C2pA;njc-Qep 809QuerFarthmo,6jnr §itcs) <br />6. W.,J) I or mm scot <br />7. W;lj 25011ru4jt.y*t* <br />FOR SJVAPCO USE ONLY <br />A8bCstQ&NN71ESW.nqv.irtrswots satisfied 0Rinpr%zrt*s <br />( .I Indirect 801pree Rev icF rcq u irctuents s.itboficd OR in progress <br />kEVjEkVXD <br />DAM <br />ReviwA 12113115 <br />.7 d ' pi t,'j Pn7- sevis puv:uul volwoo d0Z:L0 13 4 £L Uer <br />Received Time Jan. 15. 2018 1:51PM No.2900 <br />