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10-25-2001 ea:12AM F11011 <br /> { SAN JOF�QUIN GOUkTYPUB1JC HEAIIH -5FRVlC-5 <br /> XIVIRQNMENTAL HEALTH DIVISIQN <br /> 404 EAST WEBER AVi=NIDE,THIRD FLOOR <br /> 5TOGIATON CA 85202 <br /> f (200)488.3420 <br /> PUBUI[t, RECOWS FLET-EASE APPLICATION <br /> - t 5 �oNfin .�cl �tuSropwaH� <br /> APPWCANT G1t��5 J;e- - —BUSIAUSIAGENCY . <br /> I ;ice 26c) 5 w <br /> ADDREs <br /> �ci37_ r(Q FAG SIMILE.�S�. <br /> FNONE - ` <br /> TIME q AQ A.M <br /> t yyp�_ � �...-. <br /> TENYATIVE�APP0iN7MQN7IPA7E.. a tram date at nppatlation vutnnittaq <br /> :. (Pleas¢ova 7 w 10 Aucirou�U¢y <br /> © CN GK SUX TO,UIPEDfIE Rr:0UE3T`$BY-00 FFfi-ttE¢UE9T PftDCLS&E.Q IN 3 PU5INESS DAYS <br /> nATE <br /> SIGNATURE OF G,rf`UCANT <br /> . Tpfyl3gp�tDRAm£LEMe+�Ts'Sl:ARGH <br /> 15U <br /> ¢Il. gDORI!55 ._ <br /> I . 3S �I - <br /> p <br /> 4H VADAT <br /> , <br /> G <br /> ENVIRONMENTAL HEALTH a ffisioN FU..ES <br /> D soup WASTE FACIIITY <br /> �{ UN E.RGRDUND TANK(USTI'CLEANUP 91TE ILOP) 61 FOOD FACILITY MOUBING 6MF.N7 WASTE.V>=HICIR <br /> OT ER CLEANUP SITE(NON•LOP) DDG t FM*L DAIRY <br /> p4 ur ERoRou ND TANK tMDNtrDRIKGhtentoYALS CHICKEN RANCH a PKP 7RFATMC PLANT <br /> {f$��1' IZDausWASTEGENBnA70R ,• ❑ PutAPERTHUWdYAPflfCH IATOlL8T6 <br /> o MDTELNiOTEL ❑ LAND USE APPLICATION 9 TEA <br /> TtE 1!.D PEFiAfiT7>=k FACILITY p POOLISPA p OT MAR{PLEA5E 9PeCtPY oval <br /> 7A17ocim)Y PEf{�C1NG p PUHUC WATER UYS.TNM <br /> 7CJ MBbICALWA&Tll. AGILITY <br /> �. up to ton Address"in the space Auvo. Select tho 1 olact)of tiles from the <br /> ►.(st li4�abov�a checking <br /> tho appropriate boX(os):, At least one file typo MUST lee Slactad. <br /> q�rl�f�ns rldtca�d above <br /> 2, EHD will notlfy the appll�-ant If any fit) flies exist. An appointment for rovtow Will bP canfi ed <br /> approximatcly live bust6e9a days but no later than tbn(10)days atter receipt of appllcatiOn Tho Ifieu <br /> will be held for a MAXIMUM of five business days for rovlow. Appolntmnnts should be&Chc dUlsd <br /> nccordintjly_ <br /> 3. A file that is ac6valy bFin9 Worked on by FHO staff may not bo tmmediatoly availabl©far ro few. A new <br /> application may be aubri'titted when the ille tat avallabia. <br /> q. Any flip not returned In{he same condition as roteasod Will be roor{lenized by EHU staff et ho axpen&e <br /> • of the apps{cant Futurp�fi]o reviews byth4 same appncant m�Y require a 3S7.0e deposit p r to review. <br /> S. 'TENTATIVE appointmoIltt(later mustbeconfinnedwith FHAstaff. <br /> 8. i Applications ratolved after 3.Do pm will be pro"*sod the next business day. <br /> G NF1RM�p AP°OlN'IME�T;9ASE <br /> tN[S4At--` <br /> PHOti6 FAx <br /> a -view DATE ,+ .. <br /> :ra r nNFIRM>rp � TCL P-01 <br />