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2004 y+ C�NIl�Et�TAL AX.TH DIEPART NT' <br /> c P. 0 $ 304 E Weber Ave 3'd Fl...5tocktotl,CA 95203 <br /> Fav 464-0138 Web'.*-WW.co.S=-,joaquin,c&uslehd <br /> ENVIRUIvPs'Li`�i I- L�+.LP I(209)458-3420 F v (2Q�} <br /> PLRNII'l--`RV'CLS PUBLIC Cpk7A )dE]LEASE APPLICATION <br /> Aucnaar: ` ` >3usan �AOF ; F11�11 <br /> aao>aa:ss: - om A CA a <br /> Ps#aN&: 10 Lb �,,� AGSfMU�: - 6 - <br /> �I 'TENNTA IV AR,- �S�M ONTMX DATC; Time: <br /> (pleas**pow 1t]bu3ine5s days th'o+'h dada of ap(S1lsapon subrtn�, <br /> T+T1 LJ opy <br /> 0 CHFCX OOX Ta tXplie)ITB REC MST,$9a.00 FEET-REQUEST PIROI�SSSEV IN 3>azlStNn"DAYS <br /> $110NATURG DF AP'PL.IGANT DATE — <br /> 00Aaron'x1t Us4 only <br /> FILE ADbiiCSS UNIT <br /> U p unit i <br /> P' 13 Unit 2 <br /> � � lJnit 3 <br /> s. Unit 4 <br /> AWL- <br /> E.NVjp.oNAALNTAL I.IEALTH DEPAPITMENT FILF-3 <br /> fN 10 WASTE FACILITY <br /> .USICtERGAOUND TANK(US Ga.1rANUP SITE{LOQ) Ca ROUP FA LITY?MENT a 8OUD WASTE VF0KGE <br /> OTHER CLtANUP SITE(NON-LOP) aD NO FACILITY Q DAIRY <br /> t1NDERGRWND TAS(M0Kl DRlHGn4Z: AU Dfl016{KENNEL c.p TRrLATMENT PLANT <br /> HAV"qua WA$T9 OCNMTOR V omcl<EN Rou 0 PUs9 pER TRL KrfAR6?/CHEM TOILZT-S <br /> MOTWW <br /> 0 TIMPERMITTED FACILM O TEL (M LA+NI)U3C Ape�LICATION SITES <br /> E5 TATf00/B0Dy PraR NG d OTHER(PLEASE SpECiI°Y) <br /> U M50KALWAVUFACILITY <br /> 1, List up to ten addresaiss in the space above- Set10ct the tyPe(s)of f1lt9 frayctt tho Itxt stiava by Check a <br /> the appropriate b x(es). At 102st one till type MUST be sejoctt�d• F_aNto 19991X4.01 sat ma <br /> to the <br /> e. <br /> 2. Off WlU no#fy tho applicant if any VHD furs exist An appoiatielpt of tmsnL for review will bUc;ation, The files <br /> approximately five business days but na Ieter th n ten('10)days after�ntC�h�puld be schedLsted <br /> will be hold for a maximum of five busittota da tezr.reviev+a. APP <br /> accordingly <br /> g, A fila 1,rtat],%actpv$iy being worked an by AHI?staff may r►ot,ba�-immediately;avaliablo for i"eevi9w. A na'w <br /> applicaiiOn may be cubmitted where the f110 is avallabte. aa>iared by ENA a4arft at the expanse <br /> d ithe same con <br /> 4. Any Elite tit retumen condition $9&00 relaaseci will.bo ravr� <br /> of the a�paPlla:e't Perturb ffie'rsviovvt by thes Sam*mppU�nt may require a <br /> Ss3,vo aepoait prior W reivlevr. <br /> moo with 5HO staff. <br /> *TENTATIVE appolntnwnt dates must Ela coif:ceasa�d ttta ext b S1rtSSs may. <br /> 6. AppliCations reGeh+'ed O t r 3=00 lam will be prcl <br /> TIME <br /> CONFIRMED APpOittiiTMENT ORATE ^ Ip�p;EraLs <br /> pA'TE r 14PlptMFt) PHONE . FAX <br /> YDS 110 ftEVpEW DATE <br /> i RVIR,1NED <br /> ri ov <br />