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Aug 25 2005 15:42 V LASERJET FRX <br />09/24/2005 15:59 464018 ENVIRONMENTAL IIITCTH <br />tJnf CnC Vcw c A m JTOAnuiN Comas <br />EIVVMO ANMZ Ar.�IODL&-LTgDErnxTNWW <br />304 East L'iielmr Avenue, 3'1 Floor, Stockton, CA, 95202••2708 <br />Telephone: (209) 4a-3420 Fax (209) 464-0138 Web. www tj8ov or¢�! <br />1- zi <br />i <br />TENTATPr=- A} "NUiSHT DATIL <br />fpfexse aava Se bush"" days aoa+ <br />18 eCK sox To EXPFDfiE RE <br />ATURE OF APPLICANT <br />n<m6xrtnON unit <br />specific tKte Prange <br />IIELEA$E APPLICATION <br />❑txvt2 ❑w,aa ❑WA4 <br />P(p,HM CLEANUP SM (MON-LAP) <br />F�Ik TANK lUjt#{pm4&.MQtpVAQ <br />�{ ttArArmdls WASTE GEe�aasoa <br />R Snaeo Pta�rxrTso FAGInY <br />O TATToateoal• Feww <br />0 patcAL WASTE PA=M( <br />_ PAGE 01 <br />�[Y�. Sae.-a..•.v---f`o e'ts 3 <br />Tirsa: _. <br />JtFai • 7w a m only •must be <br />r <br />ornvl-rtE¢ar sT r€"W3 m s usls oA <br />-- DATE <br />I UnKS = nnK4 ❑ OII+M`lai"d"'i=taWa+epei <br />t]{b USE ONLY <br />0 8L + <br />t{EALTN OEPp.R77AENT Fll.FS• <br />0 f OU&m6 AeATMMU <br />0 FWPFAcnm <br />❑ Uoo r <br />0 �Ra cN <br />C1 POMJSP <br />0131 3m tn"�5m <br />0 Sat ®1A. <br />0 yr s To. <br />0 DA= <br />O wA67:WAM <br />❑ puwm Tmclo <br />'Mt Are Uss A"tM <br />1. list up to ten addresses In the space above. Select the.typa(a) of ores rrom �e w• ----- -, - <br />apprupriate box(es). At toast one Tile tyPe 1�tisT be telecte� Fax to (2031484-0ie3 Ae aide <br />Indkated abov AondMt recei <br />ved es will not b& affer 300 pm wi�tf be processed th nexpted -for additional t b ss day. <br />the EM. <br />APPG will be confirnT9d <br />2. The EHD will Notify the applicant tF any EHD files exist. An appolatmont For review <br />¢pproximatety ten (10) days after receipt Of aPPticatl*M The files will be held for a maximum of tt" bua <br />days for review. Appointments should be scheduled accordingly. <br />S. A file that is actively, being worked on by EHO staff may not be Immediately available for review. A new <br />applicalron may be submitted when the file Is available. <br />4' in the same <br />rsicardthe <br />se <br />appl-"tFrcWmOd uure file reviewsbytheame applarttmay require a $93.00 depositPdOrrto review. <br />