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M LOG KUWItP <br /> CES <br /> '�:Wpz;EIVO . U1N COUNTfPtJEUC HEAL-TH $EU <br /> � � SAN � C� EALTH gtiV1SIaNl <br /> ENVIRONMENTAL H re--2 <br /> ~ G� 304 T WI:I5ER AVpi�ItJI:,TtilRO Fi � f <br /> STOCKTON CA 93202 V��i ' <br /> C� 1249)400-34W �. <br /> ' PUBLIG,REGO�tDS RELEASE p►ppL1ATl }N OZOOQ <br /> 14 <br /> �wP>JCAxT auslNaes�Ac c'r_._� ENVIRONMI=(`;ral10 1 An _ WEALTH .. <br /> ADDRJ is `1 L �cEs <br /> PHONE � FAC$lAI[iLE II <br /> TENTATIVV APPOINTMENT DATE S Ob <br /> (Pleeire{ire r DO 1Q business aws i;ii date of appikat"50mwd) <br /> I� ;I <br /> C4tECjK%0X T'O Wr oIT6 R54UGMT-$18-00 Rt -RF4 P USED IK 2 QU31MRSS DAYS <br /> 4hq 160 <br /> SIGNATURE OF APPLICANT 11 � DATi: <br /> 1110, XI <br /> FILE AEORESS ! 1'1iks;IB1E7!!E9 S CAFP U d i Y <br /> PhOGALil�1 ELFii�N'!"R$EARGtt I <br /> �I <br /> r C b - <br /> ` � �3 3 Il VZ <br /> it <br /> r <br /> �1 F <br /> !1 <br /> �l F <br /> ENVIRONMENTAL HEALTH DFV1310N FILES <br /> IINIDERGROIINDTANK(UST)CLEANUP S17E LLOP) O HOUSING ASATEIINT 0 DAIRARY <br /> ! 0 SOLID WASTE IE FAOILM <br /> OTHER C"ANUP WM pdONAMPI 0 FOOD FACILITY I� G F) WsSTE V£FIICLE <br /> UNDUR(WOUND TANK IA OfflT=KGIi�MLNAL) Lu DOC aNNi&L '!� <br /> k AZARDOW WARM OENERATOR 0 CHICKEN RANCH C1 pK�3 TFtEAlTdI1E1+lT PLANT <br /> Q MVMI N0TR1. 1 tTOLM) <br /> n riaaxt:a *crfCn FAcusTY M PuMMA-11MYARING14I o LAND USE APPLICATION SITES <br /> 3 O TATi'GOIIIOD'1"PEIRC1N6 0 VQpUEtPA <br /> 0 MEn1CAL WASTE F,ACILM C1 PUBLIC WATER SYSTEbt j� ¢7Nsriz[PI.EAIIE$PELF,'AMM <br /> ]i iF <br /> 1. List up to ten addressog in the Spac.a above. Salact the tyP (s)at files from the Ilst above by char-king <br /> tris tlpproprIM4 box(e5)-.At IS&$,one file type MUtiT be St 104 tact. OlIx to (24181 ff4&138 or aiil121be <br /> addEj2S Indlcat6_ab2y% <br /> z. CHI)will noM the aAppucard If any ZIND flies exist, An appoinIment for review will be confirmed <br /> approximately live business days but no later than tan(10)#l0ys a ter r apt of applieetlan. The files <br /> W111 be held for a rnWMum of five business asys for review? Appointments should be scfwdulad <br /> accordingly. 11 11 <br /> 3. A fila thgt to aCtWy balm worked on by E"o staff may not be immedlately available far review. A new <br /> applicz6on mey be submitted when the fila Is avallable. ; E <br /> q, Any 1114*clot rctumed In t11A same congluan as relmea will be reorgaxnlasd by EHD staff at the expense <br /> of the applicant. Future file reviews by the Kama applICAM r0iy r841 uIre a$T8.00 dapoalt prior to review. <br /> S. *TENTATIVE uppainUnellt dates mint be Cahfrmad with EKD 6tl <br /> 6. Applleations received Aflsr 3:40 pm wlil be processed dw.next buihlinOss day. <br /> i� <br /> CONFIRMED APPOWMENT DATE TIME <br /> Ik ' <br /> DATE CONFIRMED PHONE FAX 1NlTIA1.S . . <br /> Il <br /> REVIEWED YES NO REVIEW DATE" <br /> I U 1 f-1L N.Iu <br /> I# I,I <br />