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I_■_�,i eGe, o{� � 20'19-,'1-'12 02:46:92(OMT) 46T Rio m: Pswel WolooiYn <br /> I■ . • ,� EMD LOGNUMBER . <br /> �■ . c / .. SAN JoAiam COUNTY <br /> 1. .. .. <br /> • •-` " ENVIRONMENTAL HEALTH DEPARTMENT <br /> NOV.1.2 2013 186.8 East Hazelton Avenue, Sfockton, CA 85205 622 <br /> Tel ;(209)468-3420.Fax:;(209).4.6A.9138.Web. 4.Ww:sjgo.V.org/ehd <br /> EMARONMEMALHEALTH•, � . ..�... <br /> PERMITISEF{VICEB PUBLIC FtECO.RDS. RELEASE APPLICATION ,,I <br /> '{�a� clfip En tr entad ..: F4. <br /> anagement}Zne, <br /> APPLICANT 4W4W lbszyn )3tJSINESs�A Etc <br /> ADRRE$S:. . OQ w..�1.C81]�112Q PJyel)Lle2!1 CITV(STATE(ZIP: jCI ]3elTtp, C 95'9 ` <br /> PHQNE(1): 9�G- -754. PHONE (2.) F.ACSIMILE;: ���-444=3! gin. . <br /> TENTAFIUE`APROlNTMENT:Af�I ;. Timei _> > _ <br /> " (pieasenildw 10 business.deys from - p T y'-must be confirmed <br /> . .. _. .- .-�? 8 atioh'submiKab.`*Tentative only -. <br /> 'aECKONI:Y.)-;REnUES.TPROCIt$SED.1N 3:91lSlNESS DAB'S ,\ • <br /> PATE. <br /> SIGNATU. PNC.'ANT .., <br /> 1W 0F.A "11/12173: <br /> fleCtronloarlfoirRatlon C List Map-Description: <br /> F.ILE.ADD.RES <br /> S. . <br /> ' '' EHD.:USE ONLX..,. <br /> . '..Atre2kfil .. ..- Str@et Nama' <br /> .. ... <br /> '. ...620 'Wiest Charter Way `. Stoo on. N b�... 'Nat <br /> �...... <br /> .. ,. .. .. .. <br /> Dr. Martin]: ..]zl lt1� r:... :i:. . .Js. B vd ��.. , . ....p unit 2 .. <br /> S 'LittiobinlStreet . NMP... sp <br /> . . . .. _ .•, . .,. , . : .. _ .T rtA Zvi P�.'. <br /> Tu;:n 1k : pnli: <br /> 5 775T <br /> ,\.. - cJ CA` ' .Units f (`i <br /> 4: <br /> 1 <br /> .. 10. - YY:�' U <br /> nit a <br /> ;Speclfjb Pate.RaOgepf:InfortnatioO.ReQue;ted: From to: <br /> ENYlJRONM,ENTAL HEALTH'.PERARTMENTFILE$ " <br /> ®UNPER9130UN0 TANK(VS:Q CLEANUP.SrTE(f_OP). " "❑-r�MEDICALWA,kTE.FACII.NY _ 12 SOLID WA&TEFACJLrrY1VEHILE �jl•P�. ' <br /> ®OTHERCLEANUP.SITE(N.PN LOP) '[]H0451NO A9ATEMENT WASTETREI ;,T.y <br /> :®UNDERGROUNDTANK(MONITORINGJREROVAL) " TFOQD FACILITY` DAIRY 4/��� <br /> ®ASOVEGROUNDTANK' DCHICKENRAN,CHIDOG.KENNEL .❑WASTEWQTERUEATMENT�PLAM 'Yl`n•II' <br /> ®HAZARDO:t1S WASTEIMAZARDOUSM((TERiALS ©MOTELIHATEL L�FUMP.E(i TRUCIdYARDICNEMICAf.,TAILEI5. 1I�� <br /> . . 'OPAOLISPA - '. :I�tJ1ND:U5EApPLICATIQN SITES <br /> . ®TIEREO RERMITTED FACILITY, Y1' <br /> Q TATTOOIBDDYPIERCING ®CO.MFLAINTIRESPONSE RECORDS D OTHER.(P{.EASESPECIF') , , <br /> ®_'WJ;I:e AND SEPTIC-PERMIT REGQRpS ARE:AVAILABLE FORRE.YJEWt ._GNDAY-FRIDAY 8:00 AM-5;OOPM(EMG4UDINCi HOLIDAYS) <br /> 1 Listuo-to ten addresses in the space above. Select the type(s).of files from the listabove by checking theappropriate <br /> `box(es), At least one file type MUST be:selected. :Fax to(209)464-0138 ormail to the address indicated above. -Address. . <br /> ". ranges.will not be accented-for additional assistance with file addresses.contact the.EHD. Applications receiyad aftpl ... <br /> i3:0Dpmwill t „ - <br /> 3: The.EHD will approximately ten(f,0). •.... <br /> :days after ret w..Appointments . <br /> -3. Afire that is -Orr ;&V (;5'f Fes-MrM O;tG�'kg Wt- at ew application may b. <br /> submitted wt. 77S W 2' SI- K!3 r <br /> 4. Any file-nota se of thea I nt. J p <br /> Future file reviews oy mesame appiieantmay require$12 "tpdor to review. "*'80XEt17s ,E9' E1' [3 U5,E QNLi tp <br /> ¢ = <br /> .... ,_ Regia cd . ' " `S�a .PP#2tCotFtA. ,�.. .. �� k xr,•` . : t - .. � 1. Y=.. :: ,� _. E : x. ;.�..... <br /> N-W siulz <br /> Received Time �ov1�j1 2013 6:47PM No. 4491 �I-z0-13��o�3aatt6� sin ✓��-fog i�b�L;�canrf}5106�,C?i <br /> d-ZO-13' rW� �ey�61(ai�rf"a �(��( �zo eMcwFtiru5-s�lytnl €,•lis t)n 1 K�3 <br />