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12/10/2001 16:56 18666 9 RYAN & FONG PAGE 02 <br /> c � 12/10/2004 15:51 46 ENVIRONMENTAL. <br /> PAGE 01 <br /> Da:rE RrMVFPEHO COG NUMBER <br /> SAN JOA.QUIN COUNT-Y <br /> F1 E+NVMONMEN'TAL HEALTp DEPARTMENT <br /> NT <br /> 304 B Weber Ave 3`'Floor Stockton,CA 95205 <br /> DEG 10 2004 (209)468-3420 Fax- (209)464-0138 Web:wtvw.cv-sett joacjtaiiz eaus/ehd 1 <br /> EPJVi! ; r0-41 'j puBP.IC Pm C( RMASY,A.PPLZCA'nON _ <br /> PEI';! " F.Rlji ��fJ(C�Cj�CXf� suslNEssrAbENCY: <br /> APPLICIWT:,y, <br /> - <br /> PHONE: <br /> TENTATIVE*APPOINWENTDATt: I I� Tbna:, <br /> (PMase allow 10 bustneas days ftM data of pppUntion oabMM91) <br /> CHECK 6OX TO EXPEDITE REQUE •593.00 FEE—REQUEST PROLE&SED IN a 131.13INES3 DAYS <br /> 43NATURE OF APPLICANT DATE <br /> Deoortr�Use omy <br /> UNIT <br /> FILE oREss <br /> s.� 150 1 it U Unit I <br /> Unitz LL, <br /> aty <br /> Unit 4 <br /> a p Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES "fir <br /> t�LINnERGROUND TANK(UST}CLEANUP SITE(I.OPj Q HOUSING ABATEMENT Q SOLID WASTE FACILITY <br /> BOTHER CLEANUP SITE(NON�OPj ❑ FOOD FACILITY Q SOLID WASTE veHICL.E <br /> dill#QFROROut{DTANKjIdONITORINC+IREMOvAII a DOG KENNM 11 DAIRY <br /> Q FIA7.4RDOUS WASTE GeNEW1TOR ❑ CHICTCcm RANCH Q PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACa.1TY ❑ MOTELilia TEL Q PER TRUCKrYARbtCHVM TOXM <br /> 11TATTOOMODY PIERCING O POOMPA LAND US8 APPLICATION 9rtEs <br /> Q MEDICAL WASTE PACILTry O OTHER FLPA.SE.Spee1 <br /> 1. List Up to ton addresses In the space above. Select the types)of files from the Gst above py checking <br /> the appropriate box(es). At least one file type MUST be selected. F Y to(2091 a A-0138 ar maiLto the <br /> �ddress indicated above <br /> 2. EHO will notify the appLnt If any CHD files exist An appointment for review will be confirmed <br /> approximately fire business days but no later than ten(In'i days after receipt of application. The files <br /> Will be held for a ma.:^.imum of five business days for review. AppollItments should be sch®duled <br /> accordingly. <br /> 3. A file that is actively being worked on by CHD staff may not be lmmedlately avail <br /> abte for review. Anew <br /> application tray bo cubmltted when the file is available, <br /> 4. Any fife not returned in the same Condition as released will be reorgan'Ezed by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applic.:tnt may Fegtdre a$93-rIt <br /> 5. "TENTATIVE appointment dates must be,Confirmed witil EHD Staff. <br /> 6, Applications reeelvW aHer 3:00 pm will bo pro49ssed the next business day. <br /> (%f3NFIFtME�rF?t51NfW(Ekf.pATE F:� ._+�n �. �..TIMEa <br /> F <br /> i7Y$CONF112ntED li�:.. _ PHONE FAX iPtffldl`s <br /> AL"ArNED st YES NO REVIEW DATE, .' <br /> /t10 e5 ✓ks.a1s. � <br />