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X101/2004 13:53 FAX 1 209 234 7727 STOCKTON Q002/002 <br /> 92/26/((�+//77��0ngYq�� �}j 464`9 -�} T * EW1R*MWWA�'�''�_AL.TH PAGE 01 <br /> MCD �/� T �' SA d OAQuIN COUNTY <br /> `I rf1N iw lvVlrw�.1 <br /> MAR 0 1 20 4 E 0NmNTA LHEALTH DEPART aiT <br /> ��22��ggEA304 E Weber Ave 3 Floor Stockton,CA 95245170 '7 <br /> ENVIRCNMENT'HT $3420 Fax: (209)454p138 Web:www.co.sazl;oagain.ca.us/chd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASF,APPIjCATION <br /> , LICAUr: LCAba� Btf9ir~IE55fAt36NCY�. r.Ja �aet- � .4S5aG. <br /> ADDRE93: 3 41 o W ,c� d. ' r a --._.. - <br /> PHONa 0 2.3 1-7-711— FACSVARE- Z c a 2 3 4 2 <br /> TENTATiYk*SENT DAW Tkw. <br /> (Please ANOW 10 brims days fvm data of xppllmuon submltia!} <br /> CHECK BOX TO E7CpEDiTE REgUESt- -00 FEE— PROCESS IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT A I' <br /> _ DATE <br /> Depa WWW Use ody <br /> FILE ADDREWUNrr <br /> Z D ,rr Q <br /> 3 0 unit f <br /> titi itCoe <br /> �+ 0LA <br /> .- ftea 17-1 ❑ Unit 2 �• <br /> s l f r r�.� .i• $50 <br /> UniE 3 <br /> s. <br /> fto <br /> Unit 4 <br /> ° r Udtt 5 <br /> Or L <br /> a. <br /> ENVIRONMOffAL HEALTH DEPARTMENT FLESPOIAWTMM <br /> icy i ` <br /> UNDERGROUND TAW([fS7)CLI:NIUP SPIE(l.M 13 HOUSING ABATEMENT 0 SOLID WAS7 ` '": <br /> OTHER CLEANUP Strive(NON4LOP) . 0 FOOD FACT M EI SOLID WAST=VEHI= <br /> UNDl;ROROUNDTANK(MONgToRtNaa c!"goVAy o DOG MNEL 0 DAIRY <br /> la WAR WS WASTE t:;MERATDR V CWCKMN RANCH a PKG TREATMENT PLANT <br /> a TIED PERMRTED FACOMY El MrnELA10TEL fl PUMPER TRUCWYAP4DXWV TOILETS <br /> 13 TATTO'dMMV PmRcum 0 POOLISPA o LAND USE APPLICA?ION SrM <br /> 13 KEDWAL WASTE(FACILITY ❑ 4THek(PLtM SPECIFY? <br /> �- Uat uP to ten addresses In the sesta above. So kat the typa(s)bf flies from the lint above lay checking <br /> the apprOPriate box(es). At feast one file type MUST Fox selected. 209 49HIS8 M Mail o <br /> Address ndlcated above. <br /> 2. EHD will nobly the applicant if any END files exist. An appointment for review will be co4kmed <br /> apgroldmately five business days but no I;I W than ten(10)days ! 1pt of appiication. The fifes <br /> WM be held for a maximum of five business days for�revlew. Appointments should be scheduled <br /> Accordingly. . . <br /> 3. A file that is actively being Worked on by EHD staff may not be immediately available for review. A now <br /> application may be submitted when the file is avaiiatile. <br /> 4- Any Elle not returned In the same condition as released wfii be reManiaed by EHD staff at the expense <br /> of the applicant. Future file reviews by the came applicant may require a EHD staff. <br /> $93.rn� <br /> Sri <br /> fentled with <br /> 5. "TENTATIVE appointment dates must be con <br /> 6. <br /> Applicatigns received after 3,00 pm drill be processed the next business days <br /> tONii?.i4 .i58fAi'rl VAT-0, <br /> fry •> • •• t•t;'•• •• .. ., •.. , s' <br /> N d `r" ,+���jy ,,��11 ��... <br /> r .r. is b Ci' `F/'N' •r.'�; r�.i.';71f f x.7.7 <br /> .1 <br /> L <br /> -YES NO . . RIr1/1EVY DATE' •,. <br /> I <br />