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- /�,� ` �./ - vvA�t1A1� 4V in•uiin� r �e �rt rm,= ri, <br /> CMV <br /> u1YTY Lov NUMBER <br /> 304 Eaat ebcr Avenue,3"Floor,Stockton <br /> �e ART?Vi <br /> oac:(209)a6t-3420 Rax:(209)46"138 W,CA <br /> 95202-2708 <br /> www.sjgay.otgZ3uu <br /> /ebdIUBLICREC4RDAMUCmT. SRICATION <br /> Aoort IONS Pe, NUsINEISIAOENCY:PHOW SS <br /> (1r.�.s'1 •t2Z Ci7Y <br /> PHONE(2)• !✓ STATE 4 <br /> PaN <br /> TENTATW AP Acsaa tic'1.5 <br /> MNT DATM .pb •Z�. <br /> (fta"slaw 10 businessdo" <br /> CHECK NOX To VPEotTE date°rsPOSaltton subMAW.•ra,aa�y.on�y a' ust beacon`-- <br /> StONATURtE OF APPLICANT T•fl�.Op pE (CASH OR CHECK ONLY).REQuES T PriOCttSSED p1�ed) <br /> uSM3 DAYS <br /> c syr o _ !)ATE <br /> 1. strrst# P titinst f»SS <br /> END USE ONLY <br /> 4. El Unit I <br /> O Unit 2 <br /> Spedpe tate isarw of Information R O Unit 6 <br /> equesbd:From <br /> EfvvfaoN�t�TAL HEALTH DEPARTMENT � �'`` <br /> G 4.taNurTi t�.r (Lop) b NT IF tvi�7 C�e�ur IE H��TurmT <br /> � ROaautotivai(MoM,r ---- dT000F�c�urr i►�na�iicamlyp ,y .__ <br /> lt"k"Out WAM oEw"MR" c110" °DW KOWIL L7 WAsia Tres <br /> VARY <br /> O Y"001st P 0 MOTUMOTIL d WASTMATaR T r�e <br /> nT pip <br /> MUMIX WASTE FACILITY ©PooLlSrA O WD QTR UMM Sr=To"n <br /> W11"ANO sVtIC ptilMMlT On=^EAU ttaoeq <br /> �. 1.1e!up t0 tea addressee <br /> AM AVAKAtiLE foR Revlar•MONO�AY•FItlOAY i:00 AJA e:pphy FbuOAvP, <br /> sus In the 0Paae above. Select the <br /> boxes}. At least one file type MUST be setec�te�daFOf files from the list aboveby ohecldng the <br /> the E3}10. gam" Address tanpee will not be accepted�for ad <br /> plipttions received atter 3:00 pm will be dhe eat assistance th file addresses,contact <br /> Z• The ENO will processed the next business day. <br /> . otif)r the aPPlk:eat H any EHp files exist. Ana i y <br /> aPAt'oxirnately tea{10}days after receipt of Application.""Ist. �°ntment for review will be confirmed <br /> days�'rev @W* The dies wlll be held for a maximum of five business <br /> APpolatmenb should be scheduled accordingly, <br /> * A Me that is actively being worked on <br /> application MAY be submitted when thea fie is available.ERD SUN not be Immediately available for review. A new <br /> 4. Arry rile not reurned in the same condition as released will be <br /> applicant• Future file renters by the earns sppticsnf to r ro°"danlxed by EHD staff at the expense of the <br /> may equlre a$93-00 deposit prior to review. <br /> FNO uN <br /> 1N11ft00i <br />