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U? -24-2001 10:20RM FR <br />TO 192542b019b P '- <br />SAN'JbAQLIIN COUNTYPUSLiC HEALTH SERVICES <br />'ENVIRONMENTAL ONMENTAL HEALTH DIVISION <br />d 304 FAST WESER AVENUE, THIRD FLOOR <br />STOCKTON CA 9520 <br />(209) 468-3410 <br />rP_ ECIC' RRC/ORDS RELEASE APPLICATION <br />APPLIC.A,PtT1SrLLKIr ��f/� htA �il��l+��Pt�+i�lV 8US1Kt55JAGENCY �LCan UP <br />ADDR5S5 _CL Z fil �Cf]L I t . _Jm) Pl�P �r ,,j v .te,4 i <br />PHONE-./ FAl'.s1M_1 <br />TENTATIVF-"APPOINTr4EW DATE- <br />YutE <br />(Pitagn Qiv'c 7/110 110 business days (r ddata o! apph"Lion suAfTltWJ} <br />CtiECX SOX TO EXPEDITE IquEs{_ pp FEE riFQUEST PRDCE5St:0 <br />IN 3 BUSINE5$ DAYS <br />SIG NAT URE OF APPLICANT �. DATE <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />-91 UN6ERGRUuN0 TANK (UST) CLEANUP 31TE (LOP) ❑ HODUNG ABATC-HENT Q SOLID WV" TEFACItITY <br />-19 OTHER CLEANUP SrrE (NON -1-04a) 0 FOW FACILITY a SOLID WASTEVEHICLE <br />UNAERGROUtW TANK C DOG Kr:NW-L D QA;RY <br />$I KAZARDQUS WASTE GENERATOR 0 CMCKEN kANCH ❑ PKG T[trATNIENT PLANT <br />[[�C TIERED P9MjTTCD'FACHITY C1 mOTELIio L Cl pUhWERTRUCtUYAFtDICNEAd 70cL)=is <br />LJ TA L7;CAL QAY Yt 1RCIL) POOt.ISPA ❑ LAND USE A"UCAT7t7N SITES <br />U mEOCCAL WASTC PactuTY G PUUUC WATT:RSY5Tr;M L-1 OTHER (PLEASE SPECIFY ASOj/E} <br />List Up to ten addresses;in the space above. Select the typs(s) of Flex from the li5tabeve by eheC*!ng <br />the dlapr0prial0 I)ox(es),'At least one file type MUST be selected, FAx o f2p9} 464.01ag fail to the <br />addre s, indFc ted above. <br />2. EHO Will notify die applicant if any EMD files exist. An appointment for review will be confirmed <br />approximately five businass clays but no later than ter? (10) days alter receipt of application. The files <br />will be held for a maximum Of five business days for review. Appointments shou <br />accordingly. Id be scheduled <br />31 A f -We that is actively belri9 worked Qn by EHD Staff may not be icrtmcdiateiy BVailablc for review, <br />appl2catiorr maybe submitted wh.ert the file is available. <br />Anew <br />4- Any file not returned in tt a same condition as released will be re' organizaa by END staff at the eXperts(; <br />of the 1pplicant. ?"417e file reviews by the $ante applicant may require a U7.00 deposit prior to review. <br />5. 'TENTATIVE appolntmerit daces must be confirmed with E D staff. <br />6. Apptic Dns roceiveti after 3:00 pm wilt t)e processed the next busincsa day_ <br />CONFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED PHONE FAX JWTIALS <br />REV1EWwp�—� <br />to QQ 14 9U07A o YES IVO REVII-- >1 RATE <br />TUTAL P.02 <br />