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12/10/2004 16:56 18669 1329 RYAN & FONG PAGE 02 <br /> 12/10/2004 15:51 46WF8 ENVIRONMENTAL OTH PAGE 01 <br /> EFSp LOG NUMBER <br /> DATE RECEIVED SAN JOA.QM COUNTY <br /> (� ENVIRC)NMEN'I'Aj EIALTU DErALRTMENT <br /> 304 E Weber Ave 3rd Floor stockton,CA 95205 A <br /> DEC 1 0 2004 (2�)46g 3420 Fax:(209)464-0138 Web:www.ca=J0a ca.vz*hd <br /> ENVIR 1" Iv't - 'I-W. PUBLIC RECo"S PXMASE A£PLICA.'Z"IbN <br /> PERNI />FRVi�}S� ��(TfC�Ct rf � _ _susn+s ssrAo>NCY: <br /> ArpUCANY:�-�,7C'- <br /> CRONE: Vt ,C7� FAGS _ <br /> TRWATIWAPPODOWrNTPATE: '`f <br /> (Please ane*To LNslneAs tlays hon+dzte of aPPrtoatron ouMnalal) <br /> CFIECK 60X70 EXDEDrrE R1=gUE •S9100 FEE-REQUEST PROCESSED IN a UUSUMS DAYS <br /> -54 <br /> DATE <br /> IGNATUREOFAPPLICANT D.M '0'AUseornv <br /> UNIT <br /> FiLt DRE35 <br /> t"e 1_C50 1 'r 0 Unit 11 t1 <br /> Unit 2 %11 <br /> 4. <br /> 5. <br /> e. Unit 4 <br /> r. <br /> a ❑ Unit 5 <br /> a. pNVIRONMENTAL HEALTH DEPARTMI NT FILES <br /> } 0 0 IJOM NC ARAMMENT O SOLID WA$u�FACILITY <br /> 6f UNDERGROUND TANK NST!CLEANUP WE(L P! ❑ FOOD FAaLrry Q SOIAD WAs7E VEW= <br /> I/OTNER CLEANUP SrrE(NON-LOP)NCilREMOVAL) ❑ DOG KEnNEI ❑ DAIRY <br /> r�UNDERORWttD TANK(tr0ln'fORi ❑ PKCTRFATMENT PLANT' <br /> ❑ HAYARDOUS WAM omERATOR t] MOTELn RANCH ❑ PERTRUCR/YARbIC1"T'oa-ETs <br /> E3 YIERFA p£RNnTED FACILITY P MoTELMOTEI USS APPLICATION SITES <br /> El TATTOMODY PIERCING O O O'rIIER TMRPoOL (ptF>SE.SPEC] <br /> A <br /> O MEDICAL WASTE FACILrrY <br /> 1. List up to ten addresses In the space above- Select the types)of fMs from the list above by checking <br /> the appmPrt3ta box(es)- At least one file type MUST be selected. Fax o 209 Q -0138 or a o the <br /> e re a In ted above. Irmed <br /> 2 Ett4 will JOUTY the applicant If any END filo;exist. An appointment for revip wilpbe coon the files <br /> appro:dmatety five business dnfi <br /> ays but no later than ten(t 0)days oRer�reen s should be SciTsduled <br /> will be held for a maximum of five business days for review. APP <br /> accordingly, worked on by EHD staff may not be immediately available for review. Anew <br /> 3. A file that is actively being <br /> application may be submitted when the file is available, <br /> 4. Any file not returned in the same eDndition as released will be reorganized by END stab at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$93- it 4+ .tl . <br /> 'S. "TENTATIVE appointment dates must be confirmed with EHD staff. _ ,; g <br /> g. App(kaiions received lifter 3:00 pm will bo processed the next business day. <br /> . . .;.:'r.;`. ..TIME <br /> `iiFIf2M `�AI?PC11N1IY�EWfgATIE 3uti':r._ <br /> :JNffldL <br /> `#'1IY'flrCONFjI21(h�D, ••.;,.:, :,; .:. .' +`"'a; .tsH - ,.. .. - <br /> FAX'." .:,., <br /> '�tLTVIENIED YE$ NO REVIEW DATE, <br /> le5foairidil Entit 5 Oils- <br />