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05/25/2005 14:11; AX 209 948"" l rQO02 <br /> DATE RECEIVED SAN JOAQUm COUNTY <br /> E•I N .ONN�,"NTAL REALX'H DEPARTMENT <br /> F <br /> :" 04 R Weber-Ave P Floor Stockton, CA 95205 <br /> 90--i <br /> • 7f <br /> Q� * 46320' ax: (209) 464-013$deb:www.co.san-joaquimmus/ <br /> P- <br /> 17 <br /> I 0 ( t91i~k C©UNT Y <br /> SAM 'VIRO NOE IC ECORI7S tELEA.SE APPLICA.TON <br /> �l <br /> APPLICANT' ao 6 SUSINESSIAG£NCY• <br /> ADDRESS: <br /> PHONE' ` ! 1 lf 5 16 FACSIMILE. 0 � �r LOA) <br /> TENTATIVE*APP611ITMENT DATE: L� Time: <br /> I <br /> ' (please allow is h dwa&orn dat f appl[catbian submittal) <br /> rs ro <br /> , N 3 BUSINESS DAYS . <br /> CHECK BOX TO EOADrM REQUEST-$93.00 FEE-REQUEST PR CC Et]1 <br /> AT <br /> d <br /> �A <br /> SIGNATURE OF APPLICANT ����' � �"``� Y a <br /> I oeoaetmwk Lka Only <br /> 5f <br /> l]Nrr1' <br /> FILE ADDRI SS <br /> E , s i7 11lI r�u> S a o p unit 1 <br /> z. . sfine -a 31-5- <br /> /U i auk G � <br /> 7. ' Sueet.!I �/K $ efC�A[J a C Unit 2 <br /> a. sued. <br /> 000000tit 3 <br /> ,f a <br /> 04 <br /> - <br /> 4 fired' ❑, <br /> Unit 5 <br /> 9. �c <br /> 'M $'ted G ., <br /> ENyjR0NM1=NTAL HEALTH DEPARTMENT FILES <br /> NDERGIioUNP TANK(UST)CL F�IiUP Srt�(LOP) C1 HOUSING ABATEMENT st,soulo WASTE FACILITY <br /> U <br /> UNDER CLEANUP SI iE(![ON CLE 0 FOOD FAC[LnY Cl SOLID WASTE VEHICLE <br /> avAl <br /> ❑ DQG tCE; <br /> NNEL EL DAIRY <br /> >b 17N0EILGRCIUND TANK(1'A4N3TORI�IGfFt1=M f CCHICK£N E-PEAT <br /> KENT PLANT <br /> Z RAZ RQOUSWASTEGENERATOR ❑ rpTELhoTEL 0 UMPEIYAR <br /> MTalLE <br /> O -IVERED PERMITTED FACILrFy LANDUSE APPLLCAONSrES <br /> G TATTOOMODYPIERCING ❑ POOLISPA <br /> b MEO[CAL WASTE FAC1LIlY ❑ OTHER(PLEASE SPECIFY) <br /> 1, List up to ten addresses in the space above. Select the typo(s) of files from the list zboye by checkin <br /> fire appropriate box(es). At least one fie type MUST be selected. Fax to 209 464-0`138 or mail to the <br /> address•indicated above. I <br /> i 2, EHO will notify the applicant if any EHD files exist an appointment for review Will be confirmed <br /> I. approximately five business days but no later than ten (10)days after receipt of application. The file: <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br />�: accordingly. . <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. Ark, <br /> application may be submitted when the file is available, <br /> 4, Any file not returned in the same condition as released will be reorganized by EHD staff at the expert <br /> of the applicant, f=uture file reviews by the same applicant may require a$93.00 depgsit prior to revi <br /> S. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> g. Applicatigns received after 3:00 pm will be processed the next business day. <br /> ON (RMD,IkPROlt17NlEN� ->.TiME <br /> ... :.: IF2IG�ED = HONE FAX :4x': v1NF114L-S <br /> r�DATE•C}OtVt* <br /> jPEVIEW DATE.. '-'%. <br /> RF -D1 j :..' YES 110 <br /> i <br />