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MRR.10.2005 10:59M W," ENVIROTECH.INC. <br /> N0.289 P.1 I <br /> DATE RECEM 1-0-� EHO LOG NUMBER <br /> RECE <br /> ly'D SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT' <br /> 304 Eaa Weber Avenue,3 I Moor, Stockton, CA 95202-2708 <br /> MAR 1 0 2005 Tel kmes(209)468-3420 Bax:(209)464-0138 Web:www.iij&ov.org/thd �� I <br /> ONWNT HEALTH Pumic RECOP.DS RELEASE APPLICATION <br /> MEW qL%% BUSINESSIAGENCY1 <br /> ADDRESS: <br /> PHONE(1):ZAt (.Cir- �s*�Z MONE(2); TAT Will-Cab 41* _FACSMMLF-- <br /> TENTATIM APpolt TmW DATE: ^WN l 'L'� Thm: o t <br /> (Pisses aper to budne"days tiG Me of aW=smbmtllal-'TentaUwe only-must be confirmed) <br /> E3 CHECK OOX TO EXPEDM REQUEST-MAO FW(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPUCANT V--- DATE 3 111010 tr <br /> UNIT=Tmaunom O urlt t O unit Z t3 Unh 2• Unit 4 f 0 unit 6 0 other(NeetronidbitileMpa) <br /> ALEEADMEcM EHD USE ONLY <br /> Stlset 6 Sheet NEW <br /> 4. a:►t u t Kt <br /> R. vle t fikeiv.. t~ <br /> 3. O -sN <br /> s. 4" - 1114k c . /)?T- r <br /> 7. L 1�, <br /> S. Ziro .a► <br /> 9• 3 _tl; ca eWL S " L_ <br /> 10. to SV Z 1 Cc P' L.O c.LZ' <br /> Specific Date Range of Inforpution Requested:From ZQQ t to <br /> N ENTAD.HEALTH IMPARif#F 1't <br /> uNO TANK(tfsn ,p sm:(LOP) a Hwsm Awrmrw in soNo WASH FAcn&NMOW <br /> 0 OTHER CLgANUP SRE(HO*LOP) 0 FOOD FACKM 0 WASTE TM <br /> D UNWRE OUNOTANKU Doo KnoM ' 0 DAIRY <br /> o MAMMA WASMOlMRATOR 0 Cro0=RAHOH A WASYEW MYWTUOITPLANT <br /> O arAaD Pa W"W FACOM G akrs"OTaL A hWMraRTRUGKIYAROiCHW TOO= <br /> !a oillooY PIE NG 0 POOLMPA C LAND USA Apu0AWN$RES <br /> D!11110"WASTEFAGI.ITY D OTHER(PLlASE$PF�`'FYi..., <br /> wr&L AND 8WW PbWI RaouPAB ARE AVAnABLE FDR RINEW- MONDAY-FitlDAY B.'00 A*-S:OOPM - 0=0MM HOL)DAYB. <br /> t. List up to ten addrenes In the space above, Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fox to t 14640438 or mall to fit--addms <br /> i Indicated above. Address ranges w9l not be accepted-for additional assistance with file addresses,contact <br /> the Eft Applies received after 3:00 pm will be processed the next business day. <br /> 2. The EHO will notify the sappiicant if any SHD fifes exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHO staff may not be immediately available for review. A new <br /> applicaflon may be submitted when the file Is available. <br /> 4. Any file not returned M the same condition as reteaW will be reorgantEed by EHO staff at the expense of the <br /> applicant. Future fits reviews by the same applicant may require a$93.00 deposit prior to review, <br /> i- <br /> tn.As <br /> i <br />