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Sent 9y: GEOCON CONSULTANTS " <br /> ) 1916 852 9132; Dec. 'r03 4:35M) Page 113 <br /> EHO LOG NUMBER <br /> DATERECE1ViIFAI <br /> p � <br /> ENVIRONMENTAL HEALTH Di-IPAHTltlEN 1 <br /> 3041-.Webi r Ave 3"1 floor Stockt0l!,CA 95205 l <br /> 6 <br /> 209)468-3420 Fnx: (209)464-0138 Web: www.ca.san-jos c}uiz�.ca.us/e� � 3 Q� 3' 19 <br /> PUBICRECO S RELEASE A�PLICA�'TC,�N:. . . .. <br /> BUSINESSIAOENCY: �' <br /> APPLICANT: �I i+ <br /> ADDRESS: SGP d <br /> PHONE: I�° a r-AGS01LE: <br /> dF <br /> TENTATIVE"APPOINTMENT DATE: <br /> (piesse altow 10 bushiesa days from dab of applIcation submttall <br /> i.7 Ct ECK a6x TO EXPEDrrE R ST Ott FEE PROCESSED IN S BUSINESS GAYS <br /> DATE. <br /> SIGNATURE,OF APPUCANT 11Msr�Ltsa`OnIY <br /> FILE AL?D}Y& <br /> Unit i . <br /> a- s a _ <br /> ,« Unft,3 7 <br /> swot <br /> GRY <br /> 6. 9tfo41 . <br /> Gt nit 4 <br /> 7 foot - - <br /> e. <br /> ' f0. BLeel <br /> ENVIRONMENTAL HEALTH D1=PARTMEN}T FILES. <br /> t1 HOUI3iHC3 AgAtEMENT ❑ SUE.' 'WASTE <br /> Cf DERGROUND TANK JUST)CLEAIifIF St1C2 RLbP1 C� Fl7tJi)fl�1LITY ❑ .StiLiD WAST <br /> VTHER CLEANUP'sm(NON-LOP) 0 DAIRY <br /> UNOERGROUN13 TANK(MONITORIN01REMOVAL) P POG KENNeL C7 PKd TRvA-nit&T PLAN't <br /> ❑ MAZMDOLISMASTE C►ENMTOR 13 CH"EN RANCH C3 PUMPED T�WGitlltAlt01CkEm TDiLETB' . <br /> ❑ TI EI?PERMiTTE[i FACILETY ❑ Mt?TE4IHOTEL CI LAND USE APPUCATION:SnVS <br /> ❑ TATroOMgpY PIERCING ❑ POOUSPA <br /> ❑ MEDICAL WASTE FACILITY <br /> ' C] O'r3iER(PLZnA9E$PECIF'�tl ' . <br /> 1 List up to ten addr9ser�s iti the space above. 8efettthe�typ> A)of files tt'orn the ilet'.$Iwvv y c ckMg <br /> tht ApptvpriMb lsox(6s). -At leltst ane€Pis type MUST be selected. <br /> aditress indirat .dQYz <br /> 2. END will notify.the appllcant If al�y D hies sxi>�t, Ar►apPatntrrtsnt far reviev+l wkfl cats ii. the files . <br /> apprbximatsly flue bueoieieea days t1E�t tto later than.t+trt(70):days cf3ntt�lettEs h ufrs6idot df d be sctleduled <br /> will.be hold fora maxilmurn Offive business days for revtev�. Apib <br /> accordingly. <br /> 3_ A file that fa activel3l tbeivig.wQ,*W"on.by EH staff mey r►fl!be 1111ttte#Isrta ly aVallabfe for revlra• A mew <br /> application-MAY be subtAlth- w—iit fbe ills(s tivnlliable.'. : :, at boo by15H0 at*"at the OX106" s <br /> 4, Any fila:not returned ltt fhN.eame i Dit+dltlon as�releas odmilil:be rear f it ri0 to MVlsw, <br /> of the appli4attt: Futuxefil xeviews:by the <br /> sarme a pl[>:ant:m8y'rAqulre s$93.x0 degas p <br /> 5. "TENTXYIVE apfpolnWent eater:theist tie.conflrmiod with ERD staff. <br /> B. Applications received'after 3:00 pm-will be processed the:naxt business day. <br /> ]ISI. lRl1�EED ApPOiNT AFENT DAT <br /> _ :.. : . . PiC►NfE �� <br /> DA'i'�'CONii^ifZME1E1 <br /> ftlulEWE4... <br /> . s.alooe <br /> wa}rsow <br />