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n , <br /> VA 14aMcEwED SO4 JOA,QUU4 COUNTY SHO LOG NUMBER <br /> 4 F HEPOK ENv R,0NMENTAL REALTu DFPi RTNMNT <br /> 600 E.Main Street,Stockton,bk 952112-3029 <br /> Telephone:(209)468-3420 irixv(209)464-0138 Web-WWW.ajg v.o <br /> 3el <br /> C ico"S RELEASE APPLICATION <br /> APPLtCAW:— ttSMuE3S1AOE7QG`Ye <br /> ADORfi99: i ,_y <br /> PNONE(1)i .. PHONE(2): FACSfWUL6: <br /> TENTATIVE"APPO"ONT PA-M. Tarns: <br /> fPtesm Allow 10 business days from date of application aubmltfal-*Tef 1&t only-moat be eonOrmali <br /> K!OX TO.mCPCDrM ROCU $9&OD; 1 H EC ONLY)-RM- AxaT FROCES"n IM a o FSt4.0 yr••.•.•,••• <br /> StG ATU EGF APPLICANTj GATE .. <br /> r <br /> Ebetr+onle inform l:lon: ❑List❑Mav-Description: <br /> EHD US!_ONLY <br /> city ._...__., <br /> ----— I-- �—2. d Unit 2 <br /> [3. <br /> 4. �rr#t <br /> 61 <br /> ti• is Unit S <br /> n <br /> Unit s <br /> apeGRt Date A&VO of lnforrtatlon Requostsd:Prom tv <br /> ENVIRONMENTAL HEALTH DEPARTMENT F <br /> No TANK(UST)cL uua 2ITr.(LOP) ©HousMQ AaAmmR r kol Iti WAM FACN f yAfteCLC <br /> rAr= <br /> FOW ACUMASTaTwENDTAW"0lUfCftl4MRMOVAL) M pgp,KOHum M DAIRY <br /> WATM OPMATOR M OftnN kAWN ©WASM-WATRR TftAYMW PLANrrMr'ACA.ITY ©MW96/HWML G PUu�enTRVOWYAROMMMTpp•6Ta <br /> PIERIM Q POOUSPA ' O LAND Um AFKr-ArAw Sema <br /> n MM)0AL WAWM FACadrY 0 On"(PLeAsE OrECMY} <br /> WELL AND SE MC PERMIT Rt!CDROS ARO AVAU•AaLE FDR RrMw. VONDAY.FmDAY R..,M AI.6.1)OM WLIADW l f AYL <br /> 1. i,iat up to fart Oddraaties 14 the apnea atbo". &feet the type(r)of flies freta the ilei obove by ahaW0 the apW"aPdate <br /> box(" At twat one fila type MUST!ie soleclAd.•Fax to fMj-484.41.38 or eaaN to the address indlrAW.hese_ <br /> a wirM ll <br /> too mp mefoorr a tdon an aaybnce with file addresses,Dontact the EHD.App1kMKiont:tem(ved after <br /> 2 Tito END wits nQ"the aWlcwd if any M files 07dst. An appointment for navtaw will be eonArmed approximately tan(toy <br /> days Altar AKA[pt of appacatiam The files will he hold for a maximum of five buAnese days for review. Appointments <br /> shouid be sohedukd aotordingiy. <br /> S. A file%at is acthrety being worked oh by EHD otaff may not be in m@diataty available for rev". A raw application may he <br /> mAmltted when ft file Is avetlable. <br /> 4, Any Me nut rreumwd.In Via eanw conditron as released wfY be teorgantad by EHD staff at the eximse of the awsloant. <br /> Fwture flle reviews by the same opptleard may require a$95.00 deposit prforto review. <br /> EHD USE ONLY <br /> a wti <br />