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11/2.312005 14:15 FAX <br /> t • l 002/002 <br /> DATIE RECFNEL7 �....�.,. ,�.. <br /> SAN JaA.QDn'i COUNTY <br /> i <br /> ENYMONMENTAL HEALTH DEPARTYMNT <br /> NOV ,& � C''�:' 304 E Weber Ave 34 Roar Stockton,CA 95245 <br /> 469.3420 Fix. (209) 464-0138 Web:www.00 sau jaaquin.ca udehd <br /> PERN,lf-r/SERVICES <br /> pUBLIc REeoxas RELEASE AxPLICATION <br /> FACSIMILE: <br /> 3 <br /> 'i MA7r&—Am-ON7MEWIDA• ; 1 <br /> (Please nftw 12 bu*mss eMy's3r m date of appilmdan submillatl j <br /> CHECK BOX To E"*sWM pZ=nT-S92A FEE-REQUEST PROCESSED IN 3 IkUSR(M DAYS !k <br /> SIGNATURE OF APPLICANT �AAA41—/ tt,�,,�Z -- DA'C'Er- <br /> 0epaftwtuse only j <br /> FLE ADDRESS: LINT <br /> ckf <br /> s+e <br /> s. run9 Z <br /> k SO—gott . ! <br /> � <br /> U3 <br /> CW <br /> .Jlk� <br /> AD MYf <br /> Sim =_yN : <br /> s r units <br /> CRf <br /> It <br /> s� <br /> ENVIRONMENTAL HEALTH DEPARTMENT BILES <br /> soWASTE FA <br /> UNDERGRQVMTANK(1ST}CLEMUP SITE(LOM � FO ;tisA13A F-MENT q SU0pLEV;H% M <br /> .GPi Q rGGO F4Ti;R CCEAUP SITE(nt4 AGLITI <br /> W UNDE RGROUtO-CMK(1dt}tlt ORINWREM MAM "LN]C tSl=tltlEL 119-QAJRY i <br /> Ja RAZAFM6iM WASTE GENERATOR 1 CN IML PKG RRErATMEW FLANS` <br /> L1 'TIERED PERIwIrr=i ACLETY t 1AR7TEL11iO1>J D PUMPERTRO WYARWCHEMTOL1FTS <br /> La TATTOOMODYPIERCING' CT POOIJSPA -L.AJtOIl3EAFF'LN�A tiS11'F5 i <br /> iaEt�tcoa wAsslEt:A aTfY P OTHER(pLEASESPECIFY} . • <br /> 1. List up to ten addresses in tha spatia abOvO. Select the type(s)of files from the List aboye;l y checking <br /> the appropriate boxes): At least one f€te type MUST be ssleated. l=ax to 120914L4-0138 ar ma11 to the <br /> address Indicated above. l <br /> EMU wilt notify the applicant if any END files existAn appointrnent for review will be Confirmed <br /> d <br /> approximately five business days but no tater than ten(10)days after receipt of application. The fres �. <br /> will be held for a max`itnucn of five business days for review. Appointments should be scheduled � <br /> �tr€cord€ngly. <br /> 3. A file that(s aictively being worked on by Erin staff M31y 4 t be immediately available for review. A�teyv <br /> application may be submitted when the file IS avai€abiea <br /> 4, <br /> Any file not returnad in the same condition as released will be reorganized by EHD staff at the expense: <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. E <br /> g, wTE.NTATM appointment dates must be confirmed with EMD staff. <br /> Applications received after a as wn will be processed the/text business day. } <br /> L.S.r�k' �..(i�'.�hE'�' '..��1NT'3�1E`�tf'�ATi~.,•r _�'°t't se' .'✓•` -T-'1�11rL: �'�'` �,r".r�_.sr+r�7z- _ ��sJz t ." <br /> ctAT #1~ <br /> # 1 :"E,YPfit}NE FA7C. _• A. - - <br /> -. <br /> REVIEWED ''CES N G REVIEWDATE' ' <br />