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1012112010 16:45 Advanced GOviromental Inc. <br /> )2094671116 P.0011001 <br /> EHD LOG NU ER <br /> OUNTY 000, <br /> OR-EuE��II ED ENVIRONMENTAL HEALSAN JOAQUIN `TH DEPARTMENT <br /> L010 600 East Malh St, Stockton,CA 95202-3029 <br /> CTL 1 eh:www.s' ov, g/e <br /> � <br /> To none: (209)468-3420 Fax: (209)484-0138 W )9 <br /> ENVIRONNIfNT NE�LI uaLIC ECIIf308_3ELEesEaPPLICAT1 -- — -- <br /> AviriH <br /> APPLICANT <br /> TENTAT <br /> : <br /> r'� gg91 S l3ENCY: �!zi 1�/TrALt <br /> ADDRESS: Straw ATFJziP: S'Fu".L�f1 YSa/s <br /> PHONE(1): ��- Y�o�-I aoG PHONE(2): �a' yb - 3 tGd� FACSIMILE: — y�0�'1111� <br /> IVE'APPOINTMENT DATE:�'�y Time: <br /> (ptsaye.now to duafmya days from dao of y pneatton yubmltul-"rantedva only-moat va aonnrtnatl) <br /> CHECK BOX TO EXPEDITE REQUEST- 1 E(C H k CHECKONLY)-REQUEST PROC SATE N GAYS <br /> SIGNATURE OF APPLICANT <br /> Electronic Informatlon: ❑Llat❑Map—Description: <br /> FILE ADDRESS EHO USE ONLY <br /> Straats Street Name city Unitt <br /> 1. ,'L/ East IVAe e. CIL C�,U71 J <br /> 2. 30y " t2 <br /> 3. QlqO <br /> l�T <br /> nit9 <br /> 4. 235 y Fs, <br /> 14 <br /> 8. r�tl�0 r. �, •• u <br /> ^` nit 4 <br /> It I i L ©G�i AUS <br /> 7. 2.1Rd ❑unit a <br /> 8. <br /> to <br /> 8. a <br /> 1 D. <br /> 8paclfla OaG Ranaa of Information Requested: From / <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES t71-f y PS <br /> G <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUBINSOUDWASTEFACILnYNEHICLE <br /> O ABATEMENT ® � <br /> OTHER CLEANUPSITENON•LOP) ❑FOOD FACILITY �WASTETIRE I.uT 1 <br /> UNDERGROUND TAN ONROfUNOIFtEMOV - ❑D00 KENNEL ❑Wq�EWATERTREATMENT PLANT <br /> OHAZARDOUa WASTE ENERATOR� <br /> CHICKEN RAS OH O FumPERTRUCUIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED 'ILffY - :.i ❑LAND USE APPLICATION SITES <br /> ❑TATT00180DY PIERCING :' Ot <br /> ❑ MEDICAL WASTE FACILITYIEELFASE SPECIFY) <br /> WzMe <br /> ANDSEPnCPERMIT RECORDS ARE AVAILA13LVFOR REVIEW: MONDAY•FRIDAYS:OOAM.6:OOPM(EXCLUDINOHOLIDAYB) <br /> list <br /> the <br /> priate <br /> to hn eddryseee In the <br /> *Pao be selected,Faxt t(208`AH4 01195 or ental,to thebaddreaa lnd eove by atgggjLUYvroAddress <br /> . At Isagt will not beselatance with fila addreaaes,contact the Ecatlone roceived a r <br /> will be pday. tgn 2. terdrelcelpt opcciflill 6e ha d for aamaxolmum of flue boa nealsl dye Tor revlow.Appointments (70) <br /> be eaheduat Is activD staff may nut be Immediately avalladle fornaw applleatlon may ba <br /> ted when the Iiia Is available. <br /> 4. Any file not returned In the gamecondition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future fie reviews by the same applicant may require e$122 deposit prior to review. <br /> 0 lb- D'• <br /> LOLll i 10 <br /> 6 3041 <br /> S. e_ 3 <br /> wiawts <br /> Env u-0e <br />