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07/08/2002 90N 12;50 HI 916 5054356 �001�001 <br /> �eIyjtafinr.6 IU:413ab ENVTf2O � LTH PACE 01 <br /> JOAQUIN COi1NTYPUBI~IC Hf=ALT`Fi "�""•�0C" `'�E� <br /> ENVIRONMENTAL HEALTH DIVISION <br /> RVECES � <br /> 304 EAST wI�BER AVENUE,THIRD>;r,00k <br /> STOCK-FON CA s5202 <br /> PUBLIC RECORDS <br /> (209) <br /> 468-3420 <br /> SE AP PLICATION <br /> APPLICANT ) i� 17 <br /> !` - /a✓' .Ll <br /> PUSINESSiAGENcy <br /> ADt7RESS� f�� (�• .Lr'Jl�lr,� � • �j -.• <br /> PHONE <br /> FACSIMILE <br /> TENTATIVE'APPOINYMCNT nATp <br /> Plea TIME <br /> f^, { flWe7l 1 s s1504Wd appll aubmlltal) ~ <br /> CHECK BOX TO EXPE"DrM REQUEST- 44 F - EGpU ST OCESS IH 3 1NES <br /> ' S DAYS <br /> SIGNN7lURE OF APPLICANT - <br /> DATE <br /> F I Ai]17RE55 THIS 510E Erlo STAFF USE ONLY <br /> �`� a I'ROGRAIN ELEMENTS S2 ARCH . <br /> tiQ 9Zf z <br /> ti <br /> [V <br /> of ,J 4- <br /> 'v V4002 <br /> W9z� <br /> ENVIRONMENTAL.HEALTH DIVISION FILES � <br /> Rb UNDERCROUHD TANK(UST)CLEANUP$lTE(LOp) 13 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> n OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑ SOIJD WASTE VEHICLE <br /> Il Uu17t�RGROUND TANK(MONITOItINGIREMOVAL) 13 Doc,KENNEL ❑ DAIRY <br /> 0 }HAZARDOUS WASTE GENERATOR b CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 11 TIEReu PI RMfTTEO FACII rIY ❑ MOTELI HOTEL E3 PUINPi RTRUCK/YARplCt1EMTDILE73 ` <br /> 0 MEDICAL <br /> WASoDy FEIRCILF ❑ POO.'SPA C1 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACII_nY ❑ PUI3LIC WATCR SYSTEM o OTHER(PLEASE SPECIFY A13Ov6) <br /> 5 <br /> 1, List up to ten addresses in the space above_ Select the types)of files from the list above by checking <br /> the appropriates box(es). At least ono file typo MUST be selected. Fax to(2091464-0138 or mail to the <br /> address indicated above. , <br /> 2. WD will notify the applicant if any EHD files exist, An appointment for review will be confirmed <br /> approximately five business days but no later than ton (10) days after racelpt of application. The files <br /> will be held for a maximum of five businoss days for review. Appointments should by scheduled <br /> accordingly. <br /> :3. A file that is actively being worked on by EHD st:Iff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not retumed ita the same Cohdition as released will be reorganized by ERD staff at the expense <br /> of the applicant_ Feature file reviews by the same applicant may require-a$89,00 deposit prior to review. <br /> 5. <br /> 'TENTATIVE appointment dates must be confirmed with END staff, <br /> Ii. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. TIME <br /> DATE CONF=IRMED � PHONE; FAX -INITIAL,S <br /> REVIEWED YES NQ RF–VIEYV D.4ZE_.. ..— <br /> •n <br /> POSt-;t1Fax Note 7671 °qI"7 t 0.}po,► <br /> g,�, Erom Ffiono a�7 L,C <br />